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Systemic fungal infections in neonates
1Department of Paediatrics, Chinese University of Hong Kong.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|September 1, 1994
Summary
Systemic fungal infections are increasingly diagnosed in very low birth weight (VLBW) infants. Early antifungal treatment is crucial for improving outcomes in these vulnerable neonates.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Mycology
Background:
- Systemic fungal infections are a growing concern in very low birth weight (VLBW) infants in intensive care settings.
- Diagnosis is challenging, often requiring a high index of clinical suspicion due to difficulties in laboratory confirmation.
- These infections were once rare but are now frequently encountered in neonatal intensive care units (NICUs).
Purpose of the Study:
- To highlight the increasing incidence of systemic fungal infections in VLBW infants.
- To emphasize the diagnostic challenges and the need for prompt treatment.
- To review the safety and efficacy of newer antifungal agents in this population.
Main Methods:
- Clinical observation and case review of VLBW infants with suspected systemic fungal infections.
- Analysis of diagnostic difficulties and laboratory test limitations.
- Evaluation of treatment responses to newer antifungal medications, including liposomal amphotericin and azoles.
Main Results:
- Systemic fungal infections are frequently diagnosed in VLBW infants requiring intensive care.
- Laboratory confirmation of fungal infections can be difficult, necessitating clinical suspicion.
- Newer antifungal drugs like liposomal amphotericin and azoles demonstrate safety and efficacy.
- Infants with elevated C-reactive protein and poor response to antibiotics are at higher risk.
Conclusions:
- Prompt and aggressive antifungal therapy is warranted for septic neonates, particularly those with elevated C-reactive protein unresponsive to antibiotics.
- Newer antifungal agents (liposomal amphotericin, azoles) are safe and effective for treating systemic fungal infections in preterm infants.
- Improved awareness, timely treatment, and advanced neonatal care are expected to enhance the prognosis for VLBW infants with systemic fungal infections.