Risk Factors and Clinical Analysis for Invasive Fungal Infection in Neonatal Intensive Care Unit Patients

Yu, Yonghua; Du, Lizhong; Yuan, Tianming; Zheng, Junhua; Chen, An; Chen, Lihua; Shi, Liping

doi:10.1055/s-0032-1329688

Cited by 44 publications

(39 citation statements)

References 16 publications

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“…Antibacterial therapy increases the density of Candida colonization by reducing the competitive pressure exerted by commensal bacteria, and receipt of broad-spectrum antibacterial antibiotics (e.g., third-generation cephalosporins) is among the most consistently identified risk factors for neonatal candidiasis. 2, 4, 8, 17, 23, 37, 43 Studies suggest that exposure to third-generation cephalosporins is associated with an approximate doubling of the risk of invasive candidiasis among ELBW infants. 2, 38 Carbapenems are likely to be increasingly used in NICUs with the emergence of multi-drug resistant Gram-negative bacteria.…”

Section: Risk Factorsmentioning

confidence: 99%

The Epidemiology and Diagnosis of Invasive Candidiasis Among Premature Infants

Kelly

Benjamin

Smith

2015

Clinics in Perinatology

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Invasive candidiasis is a leading infectious cause of morbidity and mortality in premature infants. Improved recognition of modifiable risk factors and antifungal prophylaxis have contributed to the recent decline in the incidence of this infection among infants. Invasive candidiasis typically occurs in the first six weeks of life and presents with non-specific signs of sepsis. Definitive diagnosis relies on growth of Candida in blood culture or cultures from other normally sterile sites, but this may identify fewer than half of cases. Improved diagnostics are needed to guide initiation of antifungal therapy in premature infants.

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Section: Risk Factorsmentioning

confidence: 99%

The Epidemiology and Diagnosis of Invasive Candidiasis Among Premature Infants

Kelly

Benjamin

Smith

2015

Clinics in Perinatology

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“…Immunosuppression is usually followed by immunodeficiency disease, serious infection, or organ transplantation. [1][2][3] However, it is difficult to achieve an effective concentration of antifungal drugs at the site of infection due to the blockade presented by the blood-brain barrier (BBB). 4,5 Amphotericin B (AMB) is the broadest spectrum systemic antifungal agent available, but is no longer the primary drug of choice for invasive fungal infection due to its inherent low solubility, poor efficacy, and nephrotoxicity.…”

Section: Introductionmentioning

confidence: 99%

“…The mixture was then dialyzed against deionized water to remove unreacted OX26. The conjugation of OX26 to the copolymer was confirmed by 1 H NMR (proton nuclear magnetic resonance) spectroscopy.…”

mentioning

confidence: 99%

Anti-transferrin receptor-modified amphotericin B-loaded PLA–PEG nanoparticles cure Candidal meningitis and reduce drug toxicity

Tang¹,

Liang²,

Zhu³

et al. 2015

IJN

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Fatal fungal infections in central nervous system (CNS) can occur through hematogenous spread or direct extension. At present, hydrophobic amphotericin B (AMB) is the most effective antifungal drug in clinical trials. However, AMB is hydrophobic and therefore penetrates poorly into the CNS, and therapeutic levels of AMB are hard to achieve. The transferrin receptor (TfR/CD71) located at the blood–brain barrier mediates transferrin transcytosis. In order to enhance the receptor-mediated delivery of AMB into CNS with therapeutic level, an anti-TfR antibody (OX26)-modified AMB-loaded PLA (poly[lactic acid])–PEG (polyethylene glycol)-based micellar drug delivery system was constructed. The prepared OX26-modified AMB-loaded nanoparticles (OX26-AMB-NPs) showed significant reduction of CNS fungal burden and an increase of mouse survival time. In conclusion, OX26-AMB-NPs represent a promising novel drug delivery system for intracerebral fungal infection.

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Section: Introductionmentioning

confidence: 99%

“…The use of wide-spectrum antibiotics, advanced care in the ICU and improved knowledge on fungal infections have potentially led to an increased incidence of invasive fungal infections (IFIs) especially in critically ill and immunosuppressed patients [2][3][4] . IFIs are shown to be often hard to diagnose and treat in critical care setting [4] . Timely management of IFIs based on risk stratification and empirical approach is shown to be of meaningful clinical benefit, meanwhile dependence on the culture results and relying on fungal biomarkers may delay clinical decisions and lead to potential complications, morbidity and mortality in such patients [5,6] .…”

Section: Introductionmentioning

confidence: 99%

Invasive candidiasis in critical care setting, updated recommendations from “Invasive Fungal Infections-Clinical Forum”, Iran

Elhoufi

Ahmadi

Asnaashari

et al. 2014

WJCCM

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Invasive candidiasis (IC) bears a high risk of morbidity and mortality in the intensive care units (ICU). With the current advances in critical care and the use of widespectrum antibiotics, invasive fungal infections (IFIs) and IC in particular, have turned into a growing concern in the ICU. Further to blood cultures, some auxil- REVIEW 102November 4, 2014|Volume 3|Issue 4| WJCCM|www.wjgnet.com iary laboratory tests and biomarkers are developed to enable an earlier detection of infection, however these test are neither consistently available nor validated in our setting. On the other hand, patients' clinical status and local epidemiology data may justify the empiric antifungal approach using the proper antifungal option. The clinical approach to the management of IC in febrile, non-neutropenic critically ill patients has been defined in available international guidelines; nevertheless such recommendations need to be customized when applied to our local practice. Over the past three years, Iranian experts from intensive care and infectious diseases disciplines have tried to draw a consensus on the management of IFI with a particular focus on IC in the ICU. The established IFI-clinical forum (IFI-CF), comprising the scientific leaders in the field, has recently come up with and updated recommendation on the same (June 2014). The purpose of this review is to put together literature insights and Iranian experts' opinion at the IFI-CF, to propose an updated practical overview on recommended approaches for the management of IC in the ICU. Core tip: The present consensus statement has attempted to summarize the practical highlights regarding the management of Invasive Candidiasis (IC) in critical care setting. This easy-to-follow clinical pathway is expected to be not only of interest but also of clinical use for those who deal with the management of invasive fungal infections in hospital setting and especially the intensive care units. The focus of this paper is the concept of timely management of IC in critically ill patients.

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Risk Factors and Clinical Analysis for Invasive Fungal Infection in Neonatal Intensive Care Unit Patients

Abstract: The predominant factors identified with IFI were third-generation cephalosporin use, peripherally inserted central venous catheter use, intubation > 6 days, any prior abdominal surgery, and neutropenia during first week of life < 1.5 · 109/L.

Cited by 44 publications

References 16 publications

The Epidemiology and Diagnosis of Invasive Candidiasis Among Premature Infants

The Epidemiology and Diagnosis of Invasive Candidiasis Among Premature Infants

Anti-transferrin receptor-modified amphotericin B-loaded PLA–PEG nanoparticles cure Candidal meningitis and reduce drug toxicity

Invasive candidiasis in critical care setting, updated recommendations from “Invasive Fungal Infections-Clinical Forum”, Iran

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Risk Factors and Clinical Analysis for Invasive Fungal Infection in Neonatal Intensive Care Unit Patients

Abstract: The predominant factors identified with IFI were third-generation cephalosporin use, peripherally inserted central venous catheter use, intubation > 6 days, any prior abdominal surgery, and neutropenia during first week of life < 1.5 · 109/L.

Cited by 44 publications

References 16 publications

The Epidemiology and Diagnosis of Invasive Candidiasis Among Premature Infants

The Epidemiology and Diagnosis of Invasive Candidiasis Among Premature Infants

Anti-transferrin receptor-modified amphotericin B-loaded PLA&ndash;PEG nanoparticles cure Candidal meningitis and reduce drug toxicity

Invasive candidiasis in critical care setting, updated recommendations from “Invasive Fungal Infections-Clinical Forum”, Iran

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Anti-transferrin receptor-modified amphotericin B-loaded PLA–PEG nanoparticles cure Candidal meningitis and reduce drug toxicity