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Candida: an increasingly important pathogen in the nursery
1Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.
Insights
Neonatal care advances increase survival of premature infants, leading to a rise in invasive candidiasis. This review covers candidal infections, focusing on risk factors, diagnosis, and treatment.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Mycology
Background:
- Neonatal intensive care advances enable survival of extremely premature infants.
- Candidiasis, a fungal infection, presents a widening spectrum of disease, with increased invasive cases.
- This necessitates a comprehensive understanding of candidal infections in vulnerable neonates.
Purpose of the Study:
- To review the history, microbiology, and epidemiology of candidal infections (superficial and invasive).
- To detail the pathogenesis and risk factors for invasive candidiasis in neonates.
- To outline clinical manifestations, diagnosis, and current treatment strategies.
Main Methods:
- Literature review of historical data, microbiological studies, and epidemiological surveys.
- Analysis of pathogenesis and risk factors for invasive candidiasis.
- Synthesis of information on clinical presentation, diagnostic approaches, and therapeutic interventions.
Main Results:
- Candidiasis has evolved, with increased incidence of invasive forms in neonatal populations.
- Specific risk factors and pathogenic mechanisms contribute to invasive candidal disease in immature infants.
- Effective diagnosis and treatment are crucial for improving outcomes.
Conclusions:
- Invasive candidiasis is a significant concern in neonatal intensive care units.
- Understanding risk factors and pathogenesis is key to prevention and management.
- Multifaceted approaches to diagnosis and treatment are essential for combating neonatal candidiasis.
Abstract:
Advances in neonatal care now permit the survival of very immature infants. Although candidiasis is not a new disease, the spectrum of clinical disease has greatly widened and the rate of invasive disease has increased significantly. This article reviews the history, microbiology, and epidemiology of candidal infections, both superficial and invasive. Particular attention is paid to the pathogenesis of and risk factors associated with the development of invasive disease, as well as its clinical manifestations, diagnosis, and treatment.