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Invasive fungal infections in neonates: a review
Kristin E D Weimer1, P Brian Smith1,2, Mihai Puia-Dumitrescu3
1Division of Neonatology, Department of Pediatrics, Duke University, Durham, NC, UK.
Abstract:
Invasive fungal infections remain the leading causes of morbidity and mortality in neonates, especially preterm and very low birth weight infants. Most invasive fungal infections are due to Candida or Aspergillus species, and other fungi are increasingly reported and described. Appropriate identification and treatment are required to augment activity and reduce the toxicity of antifungal drugs. Successful use of antifungals in the vulnerable neonatal population is important for both prevention and treatment of infection. Strategies for prevention, including prophylactic antifungal therapy as well as reducing exposure to modifiable risk factors, like limiting antibiotic exposure, discontinuation of central catheters, and hand hygiene are key techniques to prevent and decrease rates of invasive fungal infections. In conclusion, this is a review of the most common causes, prevention strategies, prophylaxis, and treatment of invasive fungal infections in neonates.
Insights
Invasive fungal infections are a major threat to neonates, particularly premature infants. This review covers common causes, prevention, prophylaxis, and treatment strategies for these serious infections.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Mycology
Background:
- Invasive fungal infections (IFIs) are a significant cause of illness and death in neonates, especially those born prematurely or with very low birth weight.
- Candida and Aspergillus species are the most common culprits, but other fungi are emerging.
- Effective identification and treatment of IFIs are crucial to improve outcomes and minimize antifungal drug toxicity in this vulnerable population.
Purpose of the Study:
- To review the common causes of invasive fungal infections in neonates.
- To discuss current strategies for the prevention and treatment of neonatal IFIs.
- To highlight the importance of prophylactic antifungal therapy and risk factor reduction.
Main Methods:
- This study is a review of existing literature on neonatal invasive fungal infections.
- It synthesizes information on epidemiology, diagnosis, prevention, and treatment.
- Focus is placed on evidence-based strategies for managing IFIs in neonates.
Main Results:
- Invasive fungal infections pose a substantial risk to neonatal morbidity and mortality.
- Prevention strategies include prophylactic antifungal therapy and minimizing exposure to risk factors.
- Key risk factors to address include antibiotic exposure, central catheter use, and hygiene.
Conclusions:
- Invasive fungal infections in neonates require prompt and accurate diagnosis and effective treatment.
- Preventive measures, including prophylactic antifungals and hygiene, are essential.
- This review provides a comprehensive overview for managing IFIs in the neonatal intensive care unit.
