Neonatal Invasive Candidiasis: Current Concepts

Abstract

Neonatal invasive candidiasis (NIC) is an important cause of morbidity and mortality, especially in preterm and very low birthweight infants, with the incidence being inversely correlated with gestational age and birth weight. Epidemiological studies in high-income countries show Candida albicans and Candida parapsilosis being the commonest species causing NIC, while in low- and middle-income countries NIC is more often caused by non-albicans Candida species with higher rates of antifungal resistance. The increased incidence of fluconazole-resistant C. parapsilosis and multi-drug-resistant Candida auris causing NIC is of concern and challenges our management approaches. Identification of the causative Candida sp. and susceptibility testing needs to be optimised to guide targeted treatment. Infection prevention and control measures are crucial to prevent neonatal Candida colonisation and the development of NIC. In this concise review, authors will discuss the global changing epidemiology of NIC, the increase of antifungal resistant Candida species and outbreaks, current management approaches, and the value of infection prevention and control measures in the prevention of NIC.