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Neonatal Invasive Fungal Infections: Epidemiology, Microbiology, and Controversies in Practice
David A Kaufman1, Sagori Mukhopadhyay2
1Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA 22903, USA.
Abstract:
As neonatology has moved to caring for infants of lower gestational ages, prevention, prompt diagnosis, and treatment of invasive fungal infections have contributed to the improved neonatal outcomes. Standardized care should include an infection prevention bundle for invasive Candida infections with targeted fluconazole prophylaxis in high-risk patients, antimicrobial stewardship, and central venous catheter-related infection prevention measures. Knowledge and vigilance with skin care, recognition of dermatologic presentation of congenital cutaneous candidiasis, and cutaneous mold infections with prompt treatment is critical for preventing morbidity and mortality associated with these infections in extremely preterm infants.
Insights
Preventing invasive fungal infections in neonates is crucial for improved outcomes. Standardized care, including antifungal prophylaxis and meticulous skin care, is essential for high-risk infants.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatrics
Background:
- Neonatology increasingly cares for extremely preterm infants, who are more susceptible to invasive fungal infections.
- Invasive fungal infections pose significant risks, including morbidity and mortality, in this vulnerable population.
Purpose of the Study:
- To highlight the importance of preventing, diagnosing, and treating invasive fungal infections in neonates.
- To outline key components of standardized care for invasive fungal infections in neonatal intensive care units.
Main Methods:
- Review of current practices in neonatal intensive care for fungal infections.
- Emphasis on infection prevention bundles, including antifungal prophylaxis and catheter care.
- Importance of recognizing dermatologic presentations of fungal infections.
Main Results:
- Standardized care bundles, including targeted fluconazole prophylaxis for high-risk neonates, improve outcomes.
- Antimicrobial stewardship and central venous catheter-related infection prevention are critical.
- Prompt recognition and treatment of cutaneous candidiasis and mold infections reduce infant morbidity and mortality.
Conclusions:
- Comprehensive strategies are vital for managing invasive fungal infections in neonates.
- Vigilance in skin care and early diagnosis of dermatologic manifestations are key.
- Improved neonatal outcomes are linked to proactive and standardized approaches to fungal infections.
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