Invasive neonatal candidiasis: an overview

Until the 1980s, recovery of Candida species from normally sterile body sites in high-risk infants was often dismissed as contamination. Such delay in diagnosis often resulted in death, multifocal disease, or significant morbidity, outcomes that still occur today. Problems establishing the diagnosis of invasive candidiasis persist, while the frequency of this infection in increasingly fragile and smaller premature infants appears to be increasing. Standard culture techniques have limited sensitivity and often take several days for recovery of Candida when positive. Heightened suspicion and improved diagnostic tools are needed. Less toxic antifungal agents with better tissue penetration profiles will help. Better understanding of risk factors and pathogenesis may permit more effective strategies for prophylaxis and appropriately targeted empiric antifungal therapy.