Does the use of oral nonabsorbable antifungal prophylaxis reduce the incidence of fungal colonization and/or systemic infection in preterm infants?

Lam, Russell A.; Dow, Kimberly

doi:10.1093/pch/18.3.134

Cited by 1 publication

(1 citation statement)

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“…Due to increased risk and susceptibility to infection, preterm infants are frequently exposed to broad-spectrum antibiotic usage [113]. Diminished bacterial biomass in the gut then allows for fungal expansion and overgrowth, with a fraction of these fungal colonization events resulting in infection [114][115][116]. Interplay among the preterm immature immune system, underdeveloped intestine, and dysbiosis, along with environmental risk factors such as total parenteral nutrition, invasive catheters and endotracheal tubes, and medications [75,79,83,112,117,118] results in systemic, invasive candidiasis in 10% of preterm infants, with a mortality rate approaching 20% [119,120] and a host of associated long-term morbidities [115].…”

Section: Preterm Invasive Fungal Infection (Ifi)mentioning

confidence: 99%

The Nonbacterial Microbiome: Fungal and Viral Contributions to the Preterm Infant Gut in Health and Disease

et al. 2023

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The intestinal microbiome is frequently implicated in necrotizing enterocolitis (NEC) pathogenesis. While no particular organism has been associated with NEC development, a general reduction in bacterial diversity and increase in pathobiont abundance has been noted preceding disease onset. However, nearly all evaluations of the preterm infant microbiome focus exclusively on the bacterial constituents, completely ignoring any fungi, protozoa, archaea, and viruses present. The abundance, diversity, and function of these nonbacterial microbes within the preterm intestinal ecosystem are largely unknown. Here, we review findings on the role of fungi and viruses, including bacteriophages, in preterm intestinal development and neonatal intestinal inflammation, with potential roles in NEC pathogenesis yet to be determined. In addition, we highlight the importance of host and environmental influences, interkingdom interactions, and the role of human milk in shaping fungal and viral abundance, diversity, and function within the preterm intestinal ecosystem.

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