Neonatal Intensive Care Unit Candidemia: Epidemiology, Risk Factors, Outcome, and Critical Review of Published Case Series

Spiliopoulou, Anastasia; Dimitriou, Gabriel; Jelastopulu, Eleni; Giannakopoulos, Ioannis; Anastassiou, Evangelos D.; Christofidou, Myrto

doi:10.1007/s11046-011-9498-3

Cited by 41 publications

(36 citation statements)

References 38 publications

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“…Historically, C. albicans has been the leading cause of invasive fungal infections; however the frequency of infections caused by non -albicans species has dramatically increased [3–5]. Numerous studies have reported that infections caused by C. parapsilosis account for 15–67% of invasive candidiasis in premature newborn infants, and in some centers this species surpasses C. albicans as the predominant cause of neonatal candidiasis [6]. Interestingly, C. parapsilosis is often associated with lower mortality rates in the human host and is significantly less virulent than C. albicans in mouse models of infections [7–12].…”

Section: Introductionmentioning

confidence: 99%

Galectin-3 plays an important role in protection against disseminated candidiasis

et al. 2013

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Recent in vitro studies have implicated galectin-3 as an important receptor in host recognition and response to specific Candida species; however its role in protection against disseminated candidiasis in vivo has not been evaluated. This study investigated the importance of galectin-3 in host defense against systemic infection with the highly virulent species Candida albicans (C. albicans), and the less virulent species, Candida parapsilosis (C. parapsilosis). Mice deficient in galectin-3 (gal3−/−) were more susceptible to infection than wild type (WT) mice. When infected with C. albicans, gal3−/− mice died significantly faster and exhibited a trend towards increased fungal burden and increased abscess formation in infected brains compared to WT mice. When infected with C. parapsilosis, gal3−/− mice had significantly higher renal fungal burdens and abscess formation compared to WT mice. To evaluate whether galectin-3 may contribute to susceptibility to candidiasis in human infants, galectin-3 levels in sera of newborn infants, a patient population uniquely susceptible to infections with both C. albicans and C. parapsilosis, were compared to serum galectin-3 levels of adults. Galectin-3 levels were significantly lower in newborn infant sera compared to adult sera. These data indicate that galectin-3 plays an important role in a murine model of disseminated candidiasis and suggest a potential mechanism of neonatal susceptibility to these infections.

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Section: Introductionmentioning

confidence: 99%

Galectin-3 plays an important role in protection against disseminated candidiasis

et al. 2013

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“…Despite improvements in antifungal prevention and treatment that came with the discovery of newer azoles and echinocandins, invasive candidiasis (IC)/candidaemia are related with high mortality rates, ranging from 36% to 63% in different studies and patients groups . For paediatric patients, fewer epidemiological data exist but mortality rates range from 7.7–26% to as high as 43–54% among neonates or infants …”

Section: Introductionmentioning

confidence: 99%

Invasive candidiasis and candidaemia in neonates and children: update on current guidelines

Tragiannidis

Tsoulas²,

Groll

2014

Mycoses

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Invasive candidiasis (IC) and candidaemia are leading causes of infectious morbidity and mortality among immunocompromised paediatric patients and those admitted to intensive care units. Despite improvements in diagnosis, prevention and treatment, both mortality rates and the economic burden of disease still remain high. To address this issue, several international societies and organisations have proposed guidelines for the management of IC/candidaemia in both neonates and children. In this article, we review current recommendations of the Infectious Diseases Society of America, the European Conference on Infection in Leukaemia, the European Society of Clinical Microbiology and Infectious Diseases and the German Speaking Mycological Society/Paul-Ehrlich Society for Chemotherapy for the management and prevention of IC/candidaemia in children and neonates.

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“…Currently, Candida parapsilosis has been recognized as the second or third most frequently isolated Candida species that causes bloodstream infection (2,3,4). C. parapsilosis infections particularly affect neonates (5,6) and surgical intensive care unit (ICU) patients (7). C. parapsilosis is often found on the hands of health care workers, which is associated with outbreak infections (7,8).…”

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confidence: 99%

Characterization of Biofilm Formation and the Role of BCR1 in Clinical Isolates of Candida parapsilosis

et al. 2014

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eIn Candida parapsilosis, biofilm formation is considered to be a major virulence factor. Previously, we determined the ability of 33 clinical isolates causing bloodstream infection to form biofilms and identified three distinct groups of biofilm-forming strains (negative, low, and high). Here, we establish two different biofilm structures among strains forming large amounts of biofilm in which strains with complex spider-like structures formed robust biofilms on different surface materials with increased resistance to fluconazole. Surprisingly, the transcription factor Bcr1, required for biofilm formation in Candida albicans and C. parapsilosis, has an essential role only in strains with low capacity for biofilm formation. Although BCR1 leads to the formation of more and longer pseudohyphae, it was not required for initial adhesion and formation of mature biofilms in strains with a high level of biofilm formation. Furthermore, an additional phenotype affected by BCR1 was the switch in colony morphology from rough to crepe, but only in strains forming high levels of biofilm. All bcr1⌬/⌬ mutants showed increased proteolytic activity and increased susceptibility to the antimicrobial peptides protamine and RP-1 compared to corresponding wild-type and complemented strains. Taken together, our results demonstrate that biofilm formation in clinical isolates of C. parapsilosis is both dependent and independent of BCR1, but even in strains which showed a BCR1-independent biofilm phenotype, BCR1 has alternative physiological functions.

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Neonatal Intensive Care Unit Candidemia: Epidemiology, Risk Factors, Outcome, and Critical Review of Published Case Series

Cited by 41 publications

References 38 publications

Galectin-3 plays an important role in protection against disseminated candidiasis

Galectin-3 plays an important role in protection against disseminated candidiasis

Invasive candidiasis and candidaemia in neonates and children: update on current guidelines

Characterization of Biofilm Formation and the Role of BCR1 in Clinical Isolates of Candida parapsilosis

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