Invasive candidiasis in pediatric intensive care patients: epidemiology, risk factors, management, and outcome.

Background: The incidence of candidemia in pediatric patients follows the same pattern of increase as in adults, but the rate of increase is greater. Pediatric patients in critical condition, particularly young infants, are especially vulnerable to invasive Candida infections (ICI), partly because of their age and severe underlying disease and partly because of the invasive procedures used.

Discussion: Central venous catheters and arterial lines, parenteral nutrition, mechanical ventilation and extended use of antimicrobials enhance the risk of ICI.

Fungal colonization in the neonatal intensive care unit: risk factors, drug susceptibility, and association with invasive fungal infections.

A prospective study was conducted to determine risk factors for fungal colonization, drug susceptibility, and association with invasive fungal infections (IFIs) in a neonatal unit. On admission and weekly thereafter, surveillance fungal cultures were taken from mouth, rectum, and trachea of neonates with expected stays of > 1 week. Fungal colonization was detected in 72 (12.

Filamentous fungi in a tertiary care hospital: environmental surveillance and susceptibility to antifungal drugs.

Objective: To evaluate filamentous fungi with respect to environmental load and potential drug resistance in a tertiary care teaching hospital.

Design: Monthly survey in 2 buildings of the hospital during a 12-month period.

Setting: Hippokration Hospital in Thessaloniki, Greece.

Candida tropicalis in a neonatal intensive care unit: epidemiologic and molecular analysis of an outbreak of infection with an uncommon neonatal pathogen.

From June to July 1998, two episodes of Candida tropicalis fungemia occurred in the Aristotle University neonatal intensive care unit (ICU). To investigate this uncommon event, a prospective study of fungal colonization and infection was conducted. From December 1998 to December 1999, surveillance cultures of the oral cavities and perinea of the 593 of the 781 neonates admitted to the neonatal ICU who were expected to stay for >7 days were performed.

Amphotericin B formulations exert additive antifungal activity in combination with pulmonary alveolar macrophages and polymorphonuclear leukocytes against Aspergillus fumigatus.

Deoxycholate amphotericin B (DAMB) and amphotericin B lipid complex (ABLC) additively augmented the fungicidal activity of pulmonary alveolar macrophages against the conidia of Aspergillus fumigatus. DAMB, ABLC, and liposomal amphotericin B similarly displayed additive effects with polymorphonuclear leukocytes in damaging the hyphal elements of A. fumigatus.

Trichosporon asahii: an unusual cause of invasive infection in neonates.

Trichosporon asahii causes white piedra, an infection of hair shafts and onychomycosis in immunocompetent patients, as well as various localized or disseminated invasive infections in immunodeficient hosts. We describe a 26-week gestation 890-g vaginally delivered female neonate who had severe respiratory distress syndrome and on the sixth day of life developed Klebsiella pneumoniae sepsis. At the same time two blood cultures were positive for T.