Candida parapsilosis Is a Significant Neonatal Pathogen: A Systematic Review and Meta-analysis
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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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Premature newborns with indwelling catheters are at increased risk for candidemia.
“Premature newborns with indwelling catheters also are at increased risk for candidemia (11–13).”
From Population-Based Active Surveillance for Culture-Confirmed Candidemia — Four Sites, United States, 2012–2016 (2019) · cites this paper as [11]
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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)
- PMC
- PMC3681839
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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