Fungal sepsis and Indications of antifungal prophylaxis and treatment in neonatal intensive care units : A review

Hassan, Mahmuda; Yasmeen, BH Nazma; Begum, Nasreen

doi:10.3329/nimcj.v6i1.23150

Cited by 5 publications

(15 citation statements)

References 18 publications

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“…This study showed that male sex was a significant predictor of the development of FI in ELBW infants. Previous studies reported that male sex was identified as a risk factor for FI, even though Candida is considered as a commensal organism in the female genitourinary tract . Thus, sex in FI is considered to be a stronger risk factor for infection than fungal colonization.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for fungal infection in extremely low birthweight infants registered in the Korean neonatal network from 2013 to 2015: Male sex and hypotension

Jung

2020

Pediatrics International

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Background: In Korea, improvement in the survival rates of extremely low birthweight (<1,000 g) infants has led to neonatal infection, especially fungal infection (FI), in the neonatal intensive care unit. The purpose of this study was to determine the risk factors for FI by analyzing the incidence of FI in extremely low birthweight infants in Korea. Methods: Data from 5,320 very low birthweight (<1,500 g) infants registered from 2013 to 2015 in the Korean Neonatal Network were analyzed. The infants were divided into two groups based on the presence or absence of FI. Results: Among infants, 1,524 with gestational ages of <27 weeks and birthweights of <1,000 g were included. The incidence of FI was 7.3% (111/1,524) and mortality of the infants with FI was 40% (44/111). The mean gestational age of infants with FI was 24.8 AE 1.0 weeks, which was significantly lower than those without FI. After logistic regression, being male, and having hypotension within 7 days of birth were independent risk factors for FI. Moreover, hypotension was strongly associated with mortality in FI. Adverse outcomes such as severe bronchopulmonary dysplasia, bacteremia, and abnormal hearing test occurred more frequently in infants with FI than non-FI. Conclusions: As male sex and hypotension within 7 days of birth increased the risk of developing FI in infants with gestational ages of <27 weeks and birthweights of <1,000 g, preventive strategies to reduce the incidence of FI are required for infants with risk factors for the development of FI.

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Section: Discussionmentioning

confidence: 99%

“…Hypotension with inotropic treatment within 7 days of birth was also a risk factor associated with mortality in FI. Although hypotension may be due to poor patient status, considering that circulatory shock may be one of the risk factors of FIs, hypotension is an important risk factor for the development of FIs in ELBW infants.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for fungal infection in extremely low birthweight infants registered in the Korean neonatal network from 2013 to 2015: Male sex and hypotension

Jung

2020

Pediatrics International

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“…These techniques can be used to reduce infectious particle load to minimal levels or at levels where conventional medication and the body’s own immune system can fight the infection. Thus, they may be particularly useful for individuals experiencing immunosuppression or young children for whom antibiotics and antifungal medication can be highly toxic [44, 45]. Extending these concepts further, future work will include tubes coated with pathogen-killing agents.…”

Section: Discussionmentioning

confidence: 99%

An introduction to antibiotic-free techniques to eliminate Staphylococcus aureus from blood

Gaitas

2015

Preprint

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14Here, we describe the implementation of three techniques for capturing and 15 killing Staphylococcus aureus in blood in vitro inside a medical tube. The first technique 16 involves capturing and removing pathogens using antibodies that are coated, via a 17 simple chemical process, on the inner walls of a modified medical tube (tube capturing 18 technique). In the second technique, a photosensitizer-antibody conjugate adheres to 19 the pathogens while in circulation. When blood flows through the same kind of tube, the 20 conjugate is activated by near-infrared (NIR) light to kill pathogens (photodynamic 21 therapy technique). For the third technique, pathogens are exposed to light in the 22 ultraviolet (UV) range while circulating through a similar tube (UV technique), which kills 23 the pathogens. 24 We spiked blood with S. aureus, starting with about 10 7 CFU/mL and ending at 25 10 8 CFU/mL after 5 hours. While the spiked bacteria rapidly grew in nutrition-rich whole 26 blood, each of the three techniques were able to independently remove between 61% 27 and 84% more S. aureus in the experimental blood sample compared to the controls 28 groups. When combined, these techniques demonstrated a removal rate between 87% 29 and 92%. 30 31

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“…The current therapeutic options that are available to treat fungemia among newborns and children are based on clinical trials in adults, since there are few comparative studies of antifungal agents in infants. The optimal treatment of fungal infection in this special population requires detailed studies on pharmacokinetics, safety and efficacy of antifungal therapies [51][52][53][54].…”

Section: Treatment Of Neonatal Fungal Infectionsmentioning

confidence: 99%

“…Fluconazole prophylaxis is effective in reducing the rate of colonization and progression to systemic infection in nursery; on the other hand, some studies have revealed that prophylactic or empiric therapy with antifungal agents may be associated with changes in Candida ecology and antifungal agent susceptibility. Actually, the fluconazole dose recommended for neonates is 6 mg/kg/ day, and maintenance doses currently used in NICUs in Europe is often higher, between 6 and 12 mg/kg [53,[56][57][58].…”

Section: Treatment Of Neonatal Fungal Infectionsmentioning

confidence: 99%

Fungal Infections in Neonatal Intensive Care

Neves¹,

Parahym²,

daSilva³

et al. 2018

Selected Topics in Neonatal Care

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Neonates represent a unique and highly vulnerable patient population. Advances in medical technology have improved the survival and quality of life of newborns, particularly those with extreme prematurity or with congenital defects. Furthermore, immunologic immaturity and altered cutaneous barriers play some role in the vulnerability of neonates to nosocomial infections. In this context, the incidence of invasive fungal infections has increased significantly worldwide, representing an important infective complication in patients hospitalized in intensive care units. Invasive fungal infections in Neonatal Intensive Care Unit (NICUs) show high mortality; being species of Candida, the most isolates etiologic agents. The better prognosis of the patient is associated with the early diagnosis and fast treatment. However, guidelines to facilitate the optimal therapy choice for the treatment of neonatal fungal disease do not exist. The current antifungal agents that are available to treat fungemia among newborns and children are based on clinical trials in adults, since there are few comparative studies of antifungal agents in infants. The most commonly used drugs for the treatment of invasive fungal infections in neonates are classified in four different classes: polyene, azoles, analogs of pyrimidines and echinocandins.

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Fungal sepsis and Indications of antifungal prophylaxis and treatment in neonatal intensive care units : A review

Abstract: not availableNorthern International Medical College Journal Vol.6(1) 2014: 6-8

Cited by 5 publications

References 18 publications

Risk factors for fungal infection in extremely low birthweight infants registered in the Korean neonatal network from 2013 to 2015: Male sex and hypotension

Risk factors for fungal infection in extremely low birthweight infants registered in the Korean neonatal network from 2013 to 2015: Male sex and hypotension

An introduction to antibiotic-free techniques to eliminate Staphylococcus aureus from blood

Fungal Infections in Neonatal Intensive Care

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