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PMID: 23340551 Published · ppublish English Journal Article Meta-Analysis Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review Systematic Review

Candida parapsilosis is a significant neonatal pathogen: a systematic review and meta-analysis.

The Pediatric infectious disease journal ·Vol. 32 ·No. 5 ·2013-05-00 ·Pages e206-16

Pammi M, Holland L, Butler G, Gacser A, Bliss JM

Abstract

Candida is the third most common cause of late-onset neonatal sepsis in infants born at <1500 g. Candida parapsilosis infections are increasingly reported in preterm neonates in association with indwelling catheters. We systematically reviewed neonatal literature and synthesized data pertaining to percentage of C. parapsilosis infections and mortality by meta-analyses. We also reviewed risk factors, virulence determinants, antimicrobial susceptibility patterns and outlined clinical management strategies. C. parapsilosis infections comprised 33.47% (95% confidence interval [CI]: 30.02, 37.31) of all neonatal Candida infections. C. parapsilosis rates were similar in studies performed before the year 2000, 33.53% (95% CI: 30.06, 37.40) (28 studies), to those after 2000, 27.00% (95% CI: 8.25, 88.37) (8 studies). The mortality due to neonatal C. parapsilosis infections was 10.02% (95% CI: 7.66, 13.12). Geographical variations in C. parapsilosis infections included a low incidence in Europe and higher incidence in North America and Australia. Biofilm formation was a significant virulence determinant and predominant risk factors for C. parapsilosis infections were prematurity, prior colonization and catheterization. Amphotericin B remains the antifungal drug of choice and combination therapy with caspofungin or other echinocandins may be considered in resistant cases. C. parapsilosis is a significant neonatal pathogen, comprises a third of all Candida infections and is associated with 10% mortality. Availability of tools for genetic manipulation of this organism will identify virulence determinants and organism characteristics that may explain predilection for preterm neonates. Strategies to prevent horizontal transmission in the neonatal unit are paramount in decreasing infection rates.

MeSH Terms
Antifungal Agents/pharmacology,therapeutic use Biofilms Candida/drug effects,pathogenicity,physiology Candidiasis/drug therapy,microbiology Drug Resistance, Fungal Humans Infant, Newborn Infant, Newborn, Diseases/drug therapy,microbiology Microbial Sensitivity Tests Risk Factors Virulence
Chemicals
Antifungal Agents
Authors & Affiliations
5 authors, click to expand affiliations / ORCID
Pammi Mohan
Department of Pediatrics, Section of Neonatology, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.
Holland Linda
Butler Geraldine
Gacser Attila
Bliss Joseph M
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Article Info
Journal
The Pediatric infectious disease journal
Abbr.
Pediatr Infect Dis J
ISSN
1532-0987
DOI
10.1097/INF.0b013e3182863a1c
Published
2013-05-00
Pages
e206-16
Language
English
Region
United States
NLM ID
8701858
PMCID
PMC3681839
Subset
IM
Grants
NIGMS NIH HHS · P20 GM103537 · United States
NCRR NIH HHS · P20 RR018728 · United States
NCRR NIH HHS · 5P20RR018728-10 · United States
NIGMS NIH HHS · 8P20GM103537-10 · United States
External Links
PubMed source DOI: 10.1097/INF.0b013e3182863a1c PMC Full Text View journal details
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