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The epidemiology and diagnosis of invasive candidiasis among premature infants

Matthew S Kelly1, Daniel K Benjamin1, P Brian Smith1

  • 1Department of Pediatrics, Duke University, Box 3499, Durham, NC 27710, USA; Duke Clinical Research Institute, PO Box 17969, Durham, NC 27705, USA.

Clinics in Perinatology
|February 14, 2015
PubMed

Insights

Invasive candidiasis is a serious infection in premature infants. Early diagnosis and antifungal prophylaxis are key to reducing infant mortality from this common neonatal sepsis cause.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pediatric Critical Care

Background:

  • Invasive candidiasis is a significant cause of death and illness in premature infants.
  • Recent declines in incidence are linked to better risk factor identification and antifungal use.
  • The infection commonly appears within the first six weeks of life with vague sepsis symptoms.

Purpose of the Study:

  • To highlight the ongoing challenges in diagnosing invasive candidiasis in premature infants.
  • To emphasize the need for enhanced diagnostic tools for timely antifungal treatment initiation.

Main Methods:

  • Review of current literature on invasive candidiasis in neonates.
  • Analysis of diagnostic limitations of traditional methods like blood cultures.
  • Discussion of clinical presentation and risk factors.

Main Results:

  • Blood cultures and sterile site cultures detect less than 50% of invasive candidiasis cases.
  • Nonspecific signs of sepsis often delay diagnosis.
  • Early life (first 6 weeks) is the critical period for infection.

Conclusions:

  • Current diagnostic methods are insufficient for early and accurate detection of invasive candidiasis in premature infants.
  • Development of improved diagnostic strategies is crucial for effective antifungal therapy and improved infant outcomes.

Keywords:
CandidaNeonatal candidiasisPremature infantsRisk factors

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