Cited by 206Antifungal resistance and susceptibilityNeonatal and Maternal InfectionsOcular Infections and Treatments

Candida parapsilosis Is a Significant Neonatal Pathogen: A Systematic Review and Meta-analysis

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Pammi, Mohan, Holland, Linda, Butler, Geraldine, Gacser, Attila, Bliss, Joseph M.·2013·Pediatric Infectious Disease Journal

Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

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  1. [139]Montagna MT Lovero G De Giglio O Invasive fungal infections in neonatal intensive care units of Southern Italy: a multicentre regional active surveillance (AURORA project) J Prev Med Hyg 2010 51 125 130 21361118

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Authors
Pammi, M., Holland, L., Butler, G., Gacser, A., & Bliss, J. M.
Affiliations
  • Baylor College of Medicine (US)
  • University College Dublin (IE)
Corresponding author
Pammi, Mohan
Venue
Pediatric Infectious Disease Journal
Published
2013-05
Volume
32
Issue
5
Pages
e206-e216
ISSN
0891-3668 (ISSN-L)
OpenAlex
W1973655697
Cited by
206
References
143
Citations by year
2026: 12 · 2025: 12 · 2024: 9 · 2023: 16 · 2022: 13 · 2021: 24 · 2020: 21 · 2019: 18 · 2018: 16 · 2017: 23 · 2016: 9 · 2015: 15 · 2014: 13 · 2013: 5
FWCI
1.82
Type
journal article
Language
en
Open access
Locations
  • The Pediatric Infectious Disease Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of General Medical Sciences (P20GM103537)
  • National Center for Research Resources (P20RR018728)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
Keywords
Candida parapsilosis, neonatal candidiasis, late-onset neonatal sepsis, preterm infants, indwelling catheter, biofilm formation, virulence factors, mortality, antimicrobial susceptibility, amphotericin B, caspofungin, echinocandins, risk factors
MeSH terms
Antifungal Agents, Candida, Candidiasis, Humans, Infant, Newborn, Infant, Newborn, Diseases, Microbial Sensitivity Tests, Risk Factors, Virulence, Biofilms, Drug Resistance, Fungal

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