Abstract
Fungal infections may complicate the neonatal clinical course, and the spectrum of therapies for their treatment in the perinatal period is limited. Polyenes, Azoles and Echinocandins represent the three classes of antifungal drugs commonly used in the neonatal period. The present review provides an overview about the most recent therapeutic strategies for the treatment of fungal infections in neonates.
Highlights
Fungal InfectionsYeasts are commensal organisms which normally colonize mucosal surfaces and skin
A further virulence factor is the production of enzymes, such as secreted aspartyl proteases (SAP), phospholipases, lipases, and hydrolytic enzymes, which allow the lysis of the cellular membrane and, the entrance into the host cells [2]
Safe and effective therapeutic strategies for the treatment of ICI in the neonatal period are limited [10, 27, 28], and Polyenes, Azoles and Echinocandins represent the three classes of antifungal drugs more commonly used in infants [Table 1; [34]]
Summary
Yeasts are commensal organisms which normally colonize mucosal surfaces and skin They display a variety of virulence factors which may potentially allow for the infection of the host organism. Possible virulence factors include the ability to undergo phenotypic switching, the expression of adhesion molecules on cell surface allowing a higher attachment to host structures, and the production of hydrolytic enzymes [19]. Fungal strains usually grow in culture medium, their identification requires large volumes of blood, which are difficult to collect in the preterm neonate. This may explain why, in this special population of patients, blood cultures may be negative for a large number of fungal bloodstream infections. 50% of fungal sepsis with negative blood cultures show a positive culture of the cerebrospinal fluid, underlying the complexity of an ICI diagnosis [12]
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