Treatment of oropharyngeal candidiasis and candidal diaper dermatitis in neonates and infants: review and reappraisal

Hoppe, J. E.

doi:10.1097/00006454-199709000-00013

Cited by 70 publications

(31 citation statements)

References 41 publications

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“…All these studies but the one performed by Harms et al [8], motivated by the increasing incidence of systemic candidiasis, were prospective. Nineteen studies [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] focused on infection. They were retrospective except two [34,37].…”

Section: Discussionmentioning

confidence: 99%

“…When the prevalence was studied, it was: 8.8% [8], 11% [16], 12.6% [25], 17% [19], 19% [6], 26.7% [4], 35.2% in controls and 16.8% in patients treated with miconazole [37], 44% in controls and 12% in patients treated with nystatin [20], 47% [18], 50% during epidemic clusters and 17.6% between clusters [6], 51% [12], 53% [11], 66% in controls and 12.5% in patients treated with nystatin [29], and 77% [15].…”

Section: Prevention Of Candida Colonization In Newbornsmentioning

confidence: 99%

“…The role of vaginal candidiasis (peripartum contamination) was suggested by Harms et al [8], Hoppe [25], and Laskus et al [29], although nondominant. It was rare for Borderon et al [3], Reef et al [14], and Rotimi et al [15].…”

Section: Prevention Of Candida Colonization In Newbornsmentioning

confidence: 99%

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Prevention of <i>Candida</i> Colonization Prevents Infection in a Neonatal Unit

et al. 2003

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This study represents a 1-year surveillance period using our epidemiology-based principles published and successfully followed since 1979: weekly culture for yeasts of oral and anal swabs, treatment with oral nystatin of all colonized newborns, and good hygiene/handwashing. Colonization was demonstrated in 23 out of 791 newborns admitted from October 1998 to September 1999. Twenty-two strains of Candida were identified: 16 C. albicans, 2 C. parapsilosis, 3 C. glabrata, and 1 C. tropicalis. Symptoms were erythema of the buttocks in 6 colonized newborns. No other culture positive for Candida could be found. Previous contamination was the main source (previous stay in an intensive care unit, rarely maternal origin). Contamination in the unit was unlikely. Eradication of Candida could be observed within 1 week. These good results, controversial in the literature, were obtained following epidemiological conclusions and support our guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Prevention Of Candida Colonization In Newbornsmentioning

confidence: 99%

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Prevention of <i>Candida</i> Colonization Prevents Infection in a Neonatal Unit

et al. 2003

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“…Although this is normally an important factor, we now know that DD development is much more complex and multifactorial, involving a series of orchestrated processes [12–22], all of these are summarized in Table 1.…”

Section: Candidiasis Associated With Diaper Dermatitismentioning

confidence: 99%

Superficial Mycoses Associated with Diaper Dermatitis

et al. 2016

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Diapers create particular conditions of moisture and friction, and with urine and feces come increased pH and irritating enzymes (lipases and proteases). Fungi can take advantage of all these factors. Candida yeasts, especially C. albicans, are responsible for the most frequent secondary infections and are isolated in more than 80 % of cases. Correct diagnosis is important for ensuring the correct prescription of topical antimycotics. Nystatin, imidazoles and ciclopirox are effective. It is important to realize there are resistant strains. Dermatophytes can infect the diaper area, with the most common agent being Epidermophyton floccosum. The clinical characteristics of dermatophytosis are different from those of candidiasis, and it can be diagnosed and treated simply. Malassezia yeasts can aggravate conditions affecting the diaper area, such as seborrheic dermatitis, atopic dermatitis, and inverse psoriasis. Additional treatment is recommended in this case, because they usually involve complement activation and increased specific IgE levels. Erythrasma is a pseudomycosis that is indistinguishable from candidiasis and may also occur in large skin folds. It is treated with topical antibacterial products and some antimycotics.

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“…Despite the importance of the nature and extent of microbial colonisation with regard to adequate treatment of diaper dermatitis, the scientific basis is weak, and many of the old studies are inadequate. Further studies to elucidate the microbiological basis of the disease are therefore warranted [15, 16]. …”

Section: Introductionmentioning

confidence: 99%

Microbiological Aspects of Diaper Dermatitis

Ferrazzini

Kaiser²,

Cheng

et al. 2003

Dermatology

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Background: The microbiological basis of diaper dermatitis is not clearly elucidated, although a better knowledge of microbial colonisation can be of importance with regard to an adequate treatment. Objective: To investigate the relevance of Candida sp. and Staphylococcus aureus colonisation in diaper dermatitis and to determine the correlation between the extent of colonisation and the severity of disease. Methods: Growth of Candida sp. and S. aureus in the perianal, inguinal and oral regions was determined by positive/negative and semi-quantitative analysis in an open, multi-centre (n = 3) study. Forty-eight children with healthy skin and 28 with diaper dermatitis were analysed. The severity of diaper dermatitis was assessed using a total symptoms score. Results: Colonisation by Candida sp. was significantly more frequent in children with diaper dermatitis as compared to those with healthy skin (perianal 75 vs. 19%; inguinal 50 vs. 10%; oral 68 vs. 25%, p < 0.0003), whereas colonisation by S. aureus at the 3 swab locations was not different (p > 0.34). There was a highly significant, positive correlation between severity of disease and extent of Candida sp. colonisation at all swab locations. Conclusions: Limited microbial colonisation in diaper dermatitis is of questionable relevance, but extensive colonisation seems to aggravate the symptoms; therefore, we suggest that semi-quantitative evaluation should be preferred to the positive/negative assessment for a differential diagnosis.

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Treatment of oropharyngeal candidiasis and candidal diaper dermatitis in neonates and infants: review and reappraisal

Cited by 70 publications

References 41 publications

Prevention of <i>Candida</i> Colonization Prevents Infection in a Neonatal Unit

Prevention of <i>Candida</i> Colonization Prevents Infection in a Neonatal Unit

Superficial Mycoses Associated with Diaper Dermatitis

Microbiological Aspects of Diaper Dermatitis

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