Candida parapsilosis and the neonate: epidemiology, virulence and host defense in a unique patient setting

Abstract

Invasive candidiasis is a common problem in premature infants that leads to high morbidity and mortality. Although Candida albicans has historically been the most prominent species involved in these infections and has therefore been the subject of the most study, Candida parapsilosis is increasing in frequency, and neonates are disproportionately affected. This article reviews unique aspects of the epidemiology of this organism as well as strategies for prophylaxis against invasive candidiasis in general. Additionally, important differences between C.parapsilosis and C.albicans are coming to light related to virulence determinants and interactions with components of host immunity. These developments are reviewed while highlighting the significant gaps in our understanding that remain to be elucidated.

Keywords::

• antifungal prophylaxis
• antifungal resistance
• Candida albicans
• Candida parapsilosis
• echinocandins
• fluconazole
• host defense
• lactoferrin
• virulence factors

Financial and competing interests disclosure

Work in JM Bliss’ laboratory was supported by grants from the National Center for Research Resources (5P20RR018728-10) and the National Institute of General Medical Sciences (8P20GM103537-10) from the NIH. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.