Prevention of Candida infection in neonates
- Mohan Pammi, MD, PhD
Mohan Pammi, MD, PhD
- Associate Professor
- Baylor College of Medicine
Candida is a major cause of neonatal infection in preterm infants, especially in extremely low and very low birth weight infants [1-4]. Successful management of neonatal candidiasis requires effective treatment of Candida infection with appropriate antifungal therapy and supportive care, and preventive measures to reduce the risk of systemic Candida infections.
The prevention of Candida infections in neonates will be reviewed here. The clinical manifestations, diagnosis, etiology, risk factors and treatment of neonatal candidal infections are discussed separately. (See "Clinical manifestations and diagnosis of Candida infection in neonates" and "Epidemiology and risk factors for Candida infection in neonates" and "Treatment of Candida infection in neonates".)
Prevention of systemic candidal infections in neonates is important because of the poor clinical outcome of neonates with candidemia. Prevention efforts have focused on the very low birth weight (VLBW, BW <1500 g) and extremely low birth weight (ELBW, BW <1000 g) infants who are at the highest risk for invasive candidal infections. (See "Epidemiology and risk factors for Candida infection in neonates", section on 'Epidemiology' and "Epidemiology and risk factors for Candida infection in neonates", section on 'Risk factors for invasive candidiasis'.)
Preventive management includes general measures that can be applied broadly to all infants in the neonatal intensive care unit; and administration of prophylactic antifungal agents, which is reserved for ELBW infants who are cared for in NICUs with a high baseline rate of systemic fungal infection.
General measures are focused upon reducing cross-infection of Candida in the neonatal intensive care unit (NICU) and risk factors that increase the likelihood of candidemia. These include:
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