Neonatal candidiasis: Epidemiologic, clinical and therapeutic aspects

Candida infections are frequent and major causes of septicemia in neonatal ICUs, and they are associated with high morbidity and mortality rates. Low-birth-weight preterm infants are especially vulnerable to these devastating infections. The most frequently encountered fungal infections are caused by Candida albicans or Candida parapsilosis. Candidal infections in very low-birth-weight neonates may present as 3 distinct syndromes: congenital candidiasis, catheter-associated fungemia, and disseminated candidiasis. Amphotericin B (with or without flucytosine) is the treatment of choice for Candida infections in neonates, but its use is often limited by severe side effects. Possible alternatives to amphotericin B include triazoles (such as fluconazole) and lipid preparations of amphotericin B.