Risk Factors for Progression to Invasive Fungal Infection in Preterm Neonates With Fungal Colonization

Manzoni, Paolo; Farina, Daniele; Leonessa, MariaLisa; d'Oulx, Elisa Antonielli; Galletto, Paolo; Mostert, M.; Miniero, R; Gomirato, G

doi:10.1542/peds.2006-1311

Cited by 149 publications

(87 citation statements)

References 32 publications

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“…Fungal colonization is considered an important predictor of progression to invasive Candida infection (ICI) (1,2). Very-low-birth-weight neonates with endotracheal Candida colonization were shown to carry an additional risk of developing systemic candidiasis (3).…”

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confidence: 99%

Association of high levels of α-defensins and S100A proteins with Candida mannan detection in bronchoalveolar lavage fluid of preterm neonates

et al. 2013

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Background: Candida mannan (Mn) detection in bronchoalveolar lavage fluid (BALF) was shown to be useful for earlier identification and preemptive therapy targeting in preterm infants at high risk of invasive Candida infection. We investigated whether early detection of Candida Mn in BALF is associated with the presence of some neutrophilic products, as markers of prenatal infection/inflammation. Methods: BALF specimens were collected during the first 48 h of life from mechanically ventilated preterm newborns. Samples were analyzed by high-performance liquid chromatography-electrospray ionization-mass spectrometry. The relative amounts of α-defensins 1-4 and S100A proteins were measured by extracted ion current peak area. Absolute and differential white cell counts in BALF were obtained. Mn antigen concentrations were determined by the Platelia Candida antigen kit. results: Twenty-five studied neonates were divided into two groups: Mn-positive group and Mn-negative group. Levels of α-defensins 1-4 and S100A12 were significantly higher in the Mn-positive group than in the Mn-negative group. Moreover, positive significant correlations between the absolute number of neutrophils and the levels of α-defensins 1-4 and S100A8 were observed. conclusion: The detection of Mn antigen in BALF of preterm infants is consistent with evidence of an innate immune response in their lungs as demonstrated by higher levels of α-defensins and S100A proteins.

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confidence: 99%

Association of high levels of α-defensins and S100A proteins with Candida mannan detection in bronchoalveolar lavage fluid of preterm neonates

et al. 2013

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“…No hubo diferencias significativas en la progresión a CI en aquellos RN con colonización de un sitio 18 . La mediana de tiempo en que se desarrolló la CI fue a los 21 días de vida 19 .…”

Section: Infectología Al Díaunclassified

“…Como se ha señalado previamente, la colonización por Candida spp es una de las principales variables a considerar en la progresión a CI 19 , en especial cuando se aísla Candida spp en ≥ 3 sitios. Los cultivos de vigilancia permiten describir y monitorizar cambios en la epidemiología local (C. albicans vs no-albicans y su patrón de susceptibilidad in vitro a antifúngicos), determinar sitios de colonización más frecuentes y a su vez la intensidad de colonización.…”

Section: Vigilancia De Colonización Por Candida Sppunclassified

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

Izquierdo

Santolaya

2014

Rev. chil. infectol.

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“…Given the high morbidity and mortality associated with neonatal IC even in the face of appropriate therapy and the association of Candida colonization with subsequent IC [70][71][72], there has been considerable interest in fluconazole prophylaxis as a strategy to reduce the overall burden of IC in the nursery. To date there have been five randomized controlled trials (RCTs) [52,[65][66][67][68], eight retrospective reviews [19,20,[73][74][75][76][77][78], and a Cochrane review [79] examining fluconazole prophylaxis in neonates.…”

Section: Neonatal Clinical Studiesmentioning

confidence: 99%

Triazole Use in the Nursery: Fluconazole, Voriconazole, Posaconazole, and Ravuconazole

Watt¹,

Manzoni²,

Cohen‐Wolkowiez³

et al. 2013

Current Drug Metabolism

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Invasive fungal infections in infants admitted to the neonatal intensive care unit are common and often fatal. The mainstay of therapy against invasive fungal infections is antifungal agents. Over the last two decades, the development and approval of these drugs evolved tremendously, and the azole class emerged as important agents in the treatment and prevention of invasive fungal infections. Among the azoles, fluconazole has been used extensively due to its favorable pharmacokinetics, excellent activity against Candida spp, and safety profile. This drug has been well studied in children but data for its use in infants are largely limited to Candida prophylaxis studies. Voriconazole, a second generation triazole, has excellent activity against Candida and Aspergillus spp. However, data on its use in neonates are extremely limited. Posaconazole and Ravuconazole are the newest agents of the triazole family. The antimicrobial spectrum of posaconazole is similar to voriconazole, but with additional activity against zygomycetes. Experience with posaconazole in children is very limited, and there are no reports of its use in infants. Ravuconazole is not approved for use by the FDA but studies in animals and humans show that it is often fungicidal and has favorable pharmacokinetics. In conclusion, the management of invasive fungal infections has progressed greatly over the last two decades with the azole antifungals playing a significant role. Related to this class, future research is needed in order to better assess dosing, safety, schedules and areas of use of these agents in infants admitted to the neonatal intensive care unit.

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Risk Factors for Progression to Invasive Fungal Infection in Preterm Neonates With Fungal Colonization

Cited by 149 publications

References 32 publications

Association of high levels of α-defensins and S100A proteins with Candida mannan detection in bronchoalveolar lavage fluid of preterm neonates

Association of high levels of α-defensins and S100A proteins with Candida mannan detection in bronchoalveolar lavage fluid of preterm neonates

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

Triazole Use in the Nursery: Fluconazole, Voriconazole, Posaconazole, and Ravuconazole

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