Invasive Candida Infections in Neonatal Intensive Care Units: Risk Factors and New Insights in Prevention

Pathogens. 2024 Aug 6;13(8):660. doi: 10.3390/pathogens13080660.

Abstract

Invasive Candida infections represent a significant cause of morbidity and mortality in neonatal intensive care units (NICUs), with a particular impact on preterm and low-birth-weight neonates. In addition to prematurity, several predisposing factors for Candida colonization and dissemination during NICU hospitalization have been identified, including prolonged exposure to broad-spectrum antibiotics, central venous catheters, parenteral nutrition, corticosteroids, H2 antagonist administration, and poor adherence to infection control measures. According to the literature, the implementation of antifungal prophylaxis, mainly fluconazole, in high-risk populations has proven to be an effective strategy in reducing the incidence of fungal infections. This review aims to provide an overview of risk factors for invasive Candida infections and current perspectives regarding antifungal prophylaxis use. Recognizing and reducing people's exposure to these modifiable risk factors, in conjunction with the administration of antifungal prophylaxis, has been demonstrated to be an effective method for preventing invasive candidiasis in susceptible neonatal populations.

Keywords: antifungal prophylaxis; fluconazole prophylaxis; invasive candida infections; neonatal candidiasis.

Publication types

  • Review

MeSH terms

  • Antifungal Agents* / therapeutic use
  • Candida / drug effects
  • Candida / pathogenicity
  • Candidiasis, Invasive* / drug therapy
  • Candidiasis, Invasive* / epidemiology
  • Candidiasis, Invasive* / prevention & control
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infection Control / methods
  • Intensive Care Units, Neonatal*
  • Risk Factors

Substances

  • Antifungal Agents