Open AccessJournal Article
Systemic fungal infections in neonates.
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TLDR
Indian liposomal Amphotericin B derived from neutral lipids (L-Amp-LRC-1) has shown good response with less toxicity and a clinical trial with this preparation has shown to be safe and efficacious in neonatal fungal infections.Abstract:
Advances in neonatal management have led to considerable improvement in newborn survival. However, early ( 72 hours) onset systemic infections, both bacterial and fungal, remain a devastating complication and an important cause of morbidity and mortality in these babies. Most neonatal fungal infections are due to Candida species, particularly Candida albicans. The sources of candidiasis in NICU are often endogenous following colonization of the babies with fungi. About 10% of these babies get colonized in first week of life and up to 64% babies get colonized by 4 weeks of hospital stay. Disseminated candidiasis presents like bacterial sepsis and can involve multiple organs such as the kidneys, brain, eye, liver, spleen, bone, joints, meninges and heart. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The diagnosis of fungemia can be made definitely only by recovering the organism from blood or other sterile bodily fluid. Amphotericin B continues to be the mainstay of therapy for systemic fungal infections but its use is limited by the risks of nephrotoxicity and hypokalemia. Newer formulations of amphotericin B, namely the liposomal and the lipid complex forms, have recently become available and have been reported to have lesser toxicity. More recently Indian liposomal Amphotericin B derived from neutral lipids (L-Amp-LRC-1) has shown good response with less toxicity. A clinical trial with this preparation has shown to be safe and efficacious in neonatal fungal infections. Compared to other liposomal preparations, L-Amp-LRC-1 is effective at lower dose and is less expensive drug for the treatment of neonatal candidiasis.read more
Citations
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Emergence of fluconazole resistance in a Candida parapsilosis strain that caused infections in a neonatal intensive care unit
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TL;DR: Genotyping with a complex DNA fingerprinting probe revealed that a single strain of C. parapsilosis with decreasing susceptibility to fluconazole was responsible for cross-infections that caused BSIs in the NICU over a 12-year period.
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Treatment of candidaemia in premature infants: comparison of three amphotericin B preparations
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TL;DR: ABCD and LamB appear to be effective, safe and well tolerated in premature infants with CBSI and renal dysfunction, and larger trials are needed before routine use can be recommended.
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Outbreak of Candida parapsilosis fungemia in neonatal intensive care units: clinical implications and genotyping analysis.
TL;DR: The results suggest that C. parapsilosis fungemia increases the morbidity and mortality of neonates but does not cause acute lethal events, and was caused by two main genotypes, possibly via cross-infection by the hands of health care workers.
References
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Journal Article
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Journal ArticleDOI
Disseminated fungal infections in very low-birth-weight infants: clinical manifestations and epidemiology.
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Journal ArticleDOI
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Journal ArticleDOI
When to suspect fungal infection in neonates: A clinical comparison of Candida albicans and Candida parapsilosis fungemia with coagulase-negative staphylococcal bacteremia.
TL;DR: In this paper, the authors performed a retrospective chart review of all neonatal intensive care unit patients with systemic candidiasis or CoNS infection between January 1, 1995 and July 31, 1998 at Duke University Medical Center.
Journal ArticleDOI
Pharmacology and toxicology of a liposomal formulation of amphotericin B (AmBisome) in rodents
TL;DR: Initial pharmacokinetic evaluations demonstrated that peak plasma concentrations of 87 and 118 mg/kg, respectively, were attained in mice and rats after injection with 5mg/kg AmBisome, and tissue accumulations of amphotericin B resulting from multiple dose intravenous administration of either conventional amphoteric in B or AmBISome were determined.
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