BACKGROUND: Candida colonization is an important predictor for development of invasive fungal infection (IFI). We investigated whether early detection of Candida mannan (Mn) in bronchoalveolar lavage fluid (BALF) reduces IFI among preterm infants. METHODS: We conducted an observational study of infants with gestational age of < or =28 weeks, where a group undergoing Candida surveillance cultures (pre-Mn detection group) was compared with a group defined after the initiation of routine use of Candida Mn detection in BALF (Mn detection group). Antifungal treatment was started based on positive microbiologic (surveillance culture or Mn-antigen assay) results. RESULTS: No significant differences were detected when the groups were compared for several predictors of IFI. IFI was observed for 12 (23%) of 51 infants in the pre-Mn detection group, and for 0 (0%) of 29 infants in the Mn detection group (P = 0.003). Surveillance cultures in the pre-Mn detection group became positive at 15.0 +/- 7.2 days after birth, whereas the mean age at time of positive Mn antigen results in the Mn detection group was 4.3 +/- 3.1 days (P < 0.0001). Among 16 infants positive for surveillance cultures, 12 (75%) developed IFI (P < 0.0001). CONCLUSIONS: This study suggests that Candida Mn detection in BALF may be useful for earlier identification and preemptive therapy targeting preterm infants at high risk of IFI.

Posteraro, B., Sanguinetti, M., Boccia, S., De Feo, E., La Sorda, M., Tana, M., Tirone, C., Aurilia, C., Vendettuoli, V., Fadda, G., Romagnoli, C., Vento, G., Early mannan detection in bronchoalveolar lavae fluid with preemptive tratment reduces the incidence of invasive Candida infections in preterm infants, <<THE PEDIATRIC INFECTIOUS DISEASE JOURNAL>>, 2010; (Settembre): 844-848 [http://hdl.handle.net/10807/23205]

Early mannan detection in bronchoalveolar lavae fluid with preemptive tratment reduces the incidence of invasive Candida infections in preterm infants

Posteraro, Brunella;Sanguinetti, Maurizio;Boccia, Stefania;De Feo, Emma;La Sorda, Marilena;Tana, Milena;Tirone, Chiara;Aurilia, Claudia;Vendettuoli, Valentina;Fadda, Giovanni;Romagnoli, Costantino;Vento, Giovanni
2010

Abstract

BACKGROUND: Candida colonization is an important predictor for development of invasive fungal infection (IFI). We investigated whether early detection of Candida mannan (Mn) in bronchoalveolar lavage fluid (BALF) reduces IFI among preterm infants. METHODS: We conducted an observational study of infants with gestational age of < or =28 weeks, where a group undergoing Candida surveillance cultures (pre-Mn detection group) was compared with a group defined after the initiation of routine use of Candida Mn detection in BALF (Mn detection group). Antifungal treatment was started based on positive microbiologic (surveillance culture or Mn-antigen assay) results. RESULTS: No significant differences were detected when the groups were compared for several predictors of IFI. IFI was observed for 12 (23%) of 51 infants in the pre-Mn detection group, and for 0 (0%) of 29 infants in the Mn detection group (P = 0.003). Surveillance cultures in the pre-Mn detection group became positive at 15.0 +/- 7.2 days after birth, whereas the mean age at time of positive Mn antigen results in the Mn detection group was 4.3 +/- 3.1 days (P < 0.0001). Among 16 infants positive for surveillance cultures, 12 (75%) developed IFI (P < 0.0001). CONCLUSIONS: This study suggests that Candida Mn detection in BALF may be useful for earlier identification and preemptive therapy targeting preterm infants at high risk of IFI.
Inglese
Posteraro, B., Sanguinetti, M., Boccia, S., De Feo, E., La Sorda, M., Tana, M., Tirone, C., Aurilia, C., Vendettuoli, V., Fadda, G., Romagnoli, C., Vento, G., Early mannan detection in bronchoalveolar lavae fluid with preemptive tratment reduces the incidence of invasive Candida infections in preterm infants, <<THE PEDIATRIC INFECTIOUS DISEASE JOURNAL>>, 2010; (Settembre): 844-848 [http://hdl.handle.net/10807/23205]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/23205
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact