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Brouwer CPJM, Theelen B, van der Linden Y, Sarink N, Rahman M, Alwasel S, Cafarchia C, Welling MM, Boekhout T. Combinatory Use of hLF(1-11), a Synthetic Peptide Derived from Human Lactoferrin, and Fluconazole/Amphotericin B against Malassezia furfur Reveals a Synergistic/Additive Antifungal Effect. Antibiotics (Basel) 2024; 13:790. [PMID: 39200089 PMCID: PMC11351325 DOI: 10.3390/antibiotics13080790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 08/15/2024] [Accepted: 08/17/2024] [Indexed: 09/01/2024] Open
Abstract
OBJECTIVE The increasing resistance of Malassezia yeasts against commonly used antifungal drugs dictates the need for novel antifungal compounds. Human lactoferrin-based peptides show a broad spectrum of antimicrobial activities. Various assays were performed to find the optimal growth conditions of the yeasts and to assess cell viability, using media with low lipid content to avoid peptide binding to medium components. METHODS In the current study, we tested the antimicrobial susceptibility of 30 strains of M. furfur that cover the known IGS1 genotypic variation. RESULTS hLF(1-11) inhibited the growth of all species tested, resulting in minimum inhibitory concentrations (MIC) values ranging from 12.5 to 100 μg/mL. In the combinatory tests, the majority of fractional inhibitory concentration indexes (FIC) for the tested strains of M. furfur were up to 1.0, showing that there is a synergistic or additive effect on the efficacy of the antifungal drugs when used in combination with hLF(1-11). CONCLUSION Results showed that hLF(1-11) could be combined with fluconazole or amphotericin for the antimicrobial treatment of resistant strains, enhancing the potency of these antifungal drugs, resulting in an improved outcome for the patient.
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Affiliation(s)
- Carlo P. J. M. Brouwer
- CBMR Scientific Inc., Edmonton, AB T6J4V9, Canada
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands; (B.T.); (N.S.)
| | - Bart Theelen
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands; (B.T.); (N.S.)
- Division of Pediatric Infectious Diseases, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Youp van der Linden
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands; (B.T.); (N.S.)
| | - Nick Sarink
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands; (B.T.); (N.S.)
| | | | - Saleh Alwasel
- College of Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi “Aldo Moro”, 70121 Bari, Italy;
| | - Mick M. Welling
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands; (B.T.); (N.S.)
- College of Sciences, King Saud University, Riyadh 11451, Saudi Arabia
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Musicante M, Bembry R, Wright TS. Tinea versicolor in a premature infant. Pediatr Dermatol 2023; 40:578-579. [PMID: 36655624 DOI: 10.1111/pde.15247] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023]
Abstract
Tinea versicolor (TV) is a fungal skin infection that classically affects adolescents and young adults. Occasionally, it may be seen on the face of infants. We report an unusual case of widespread cutaneous TV in a premature infant.
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Affiliation(s)
- Meryl Musicante
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Raina Bembry
- Department of Dermatology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Teresa S Wright
- Department of Dermatology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Tomic S, Kuric I, Kuric TG, Popovic Z, Kragujevic J, Zubonja TM, Rajkovaca I, Matosa S. Seborrheic Dermatitis Is Related to Motor Symptoms in Parkinson’s Disease. J Clin Neurol 2022; 18:628-634. [DOI: 10.3988/jcn.2022.18.6.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Svetlana Tomic
- Department of Neurology, Osijek University Hospital Centre, Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Igor Kuric
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department for Dermatology and Venereology, Osijek University Hospital Centre, Osijek, Croatia
| | - Tihana Gilman Kuric
- Department of Neurology, Osijek University Hospital Centre, Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Zvonimir Popovic
- Department of Neurology, Osijek University Hospital Centre, Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Jagoda Kragujevic
- Department of Neurology, Osijek University Hospital Centre, Osijek, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Tea Mirosevic Zubonja
- Department of Neurology, Osijek University Hospital Centre, Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Ines Rajkovaca
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Gastroenterology, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
| | - Sara Matosa
- Department of Neurology, Osijek University Hospital Centre, Osijek, Croatia
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Malassezia furfur Emergence and Candidemia Trends in a Neonatal Intensive Care Unit During 10 Years: The Experience of Fluconazole Prophylaxis in a Single Hospital. Adv Neonatal Care 2020; 20:E3-E8. [PMID: 31306235 PMCID: PMC7004458 DOI: 10.1097/anc.0000000000000640] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Because Candida spp is a major cause of mortality and morbidity in preterm infants, fluconazole prophylaxis has been suggested by some experts and hospital policy. In our hospital, fluconazole prophylaxis was used in eligible preterm infants and set as the neonatal intensive care unit (NICU) practice in 2014. PURPOSE This study focused on fungal bloodstream infections and aimed to evaluate the benefit and harm of fluconazole prophylaxis. METHODS/SEARCH STRATEGY This retrospective, descriptive study involved medical record reviews in our hospital from April 2005 to October 2016. NICU patients were included if Candida species, yeast-like organisms, or Malassezia species were cultured from their venous catheter tips or blood cultures. FINDINGS/RESULTS After fluconazole prophylaxis, cases of Candida spp decreased and those of Malassezia furfur emerged. We reviewed 19 cases of catheter-related M furfur colonization and 1 case of M furfur fungemia. The gestational age was 27.3 ± 2.0 weeks and birth weight was 959.2 ± 229.8 g. Hyperalimentation with lipid infusion was used in all cases. All of the neonates survived with antifungal agent use. IMPLICATIONS FOR PRACTICE This study highlights that prophylactic fluconazole may be an associated factor of Malassezia colonization; M furfur remains a potential concern for fungemia in the care of premature infants and thus requires our attention. IMPLICATIONS FOR RESEARCH Future studies should further investigate the incidence and impact of noncandidal fungal infections with fluconazole prophylaxis use in premature infants.
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Skin Colonization by Malassezia spp. in hospitalized neonates and infants in a tertiary care centre in North India. Mycopathologia 2014; 178:267-72. [PMID: 25037485 DOI: 10.1007/s11046-014-9788-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 07/09/2014] [Indexed: 10/25/2022]
Abstract
Malassezia, a skin colonizer, is associated with multiple skin disorders in adults, and cephalic pustulosis and folliculitis in children. It can cause fungemia in infants and neonates. The time and pattern of colonization, risk factors associated with colonization and causing fungemia in children, are not well understood. The prospective cohort study was conducted to determine the rate of Malassezia species colonization and associated factors in hospitalized neonates and infants. Consecutive 50 neonates and infants admitted in neonatal and pediatric intensive care units were studied. The skin swabs were collected on the day of admission and every fifth day, thereafter, till the patient was discharged or died. Putative risk factors for the colonization of Malassezia species were recorded. Isolates were identified by phenotypic methods and sequencing of the D1 and D2 region of rDNA. Neonates were not colonized at the time of entry in neonatal ICU or at birth. Nineteen (38 %) neonates were colonized with Malassezia species during their hospital stay. Among the infants, three (6 %) came to ICU with Malassezia colonization and 26 (52 %) acquired Malassezia during ICU stay. Mechanical ventilation, duration of hospital stay, central venous catheterization, and antifungal therapy were the significantly associated factors for colonization. Malassezia furfur was the most common species isolated from the skin of infants and neonates. Colonization by Malassezia species in infants and neonates in a hospital is not uncommon and can be a potential source of nosocomial infection.
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Tragiannidis A, Bisping G, Koehler G, Groll AH. Minireview:Malasseziainfections in immunocompromised patients. Mycoses 2010; 53:187-95. [DOI: 10.1111/j.1439-0507.2009.01814.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Ayhan M, Sancak B, Karaduman A, Arikan S, Sahin S. Colonization of neonate skin by Malassezia species: relationship with neonatal cephalic pustulosis. J Am Acad Dermatol 2007; 57:1012-8. [PMID: 17889963 DOI: 10.1016/j.jaad.2007.02.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2006] [Revised: 02/20/2007] [Accepted: 02/20/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Colonization of neonate skin by Malassezia species and their causative role in neonatal cephalic pustulosis is unclear. OBJECTIVES We sought to determine the skin colonization by Malassezia in healthy newborns, and to investigate its association with neonatal cephalic pustulosis. METHODS Samples for Malassezia colonization were taken from cheeks and scalps of 104 neonates between 24 and 72 hours after birth, and again 2 or 4 weeks later. Pustules were sampled with concomitant nonlesional skin cultures if neonatal cephalic pustulosis was diagnosed. RESULTS Malassezia colonization increased significantly with age of the neonate (5% at the first week, 30% at 2-4 weeks). In all, 26 patients were given the diagnosis of neonatal cephalic pustulosis during follow-up. No correlation was found between the severity of the disease and Malassezia isolation. Skin colonization of patients with neonatal cephalic pustulosis (20.8%) was not higher than colonization of healthy newborns (37%). LIMITATIONS Not all of the neonates were examined by the authors at the second visit. CONCLUSIONS Malassezia colonization increases after the first week of life. No correlation was found between neonatal cephalic pustulosis and Malassezia.
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Affiliation(s)
- Meltem Ayhan
- Department of Dermatology, Hacettepe University, Ankara, Turkey
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Ashbee HR, Leck AK, Puntis JWL, Parsons WJ, Evans EGV. Skin colonization by Malassezia in neonates and infants. Infect Control Hosp Epidemiol 2002; 23:212-6. [PMID: 12002236 DOI: 10.1086/502037] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To identify the timing, pattern, and determinants of colonization of neonates by Malassezia. DESIGN Prospective observational study. SETTING A neonatal medical and surgical unit consisting of 10 special care, 10 high-dependency, 10 intensive care, and 10 surgical cots. PARTICIPANTS All neonates (< or = 28 days of age) or infants (> 28 days of age) admitted to the unit during the 20-week period from October 1995 to March 1996. METHODS All infants or neonates were swabbed on the day of admission and every third day thereafter and risk factors were collected for every day on the unit. RESULTS During the study period, 245 neonates and 42 infants were sampled for their entire duration of stay on the unit. Of these, 41 infants (97.6%) were colonized with Malassezia on admission to the unit and thereafter, as assessed by subsequent samples. Within the neonate population, 78 (31.8%) became colonized, but none were colonized immediately after birth. Univariate analysis showed that many factors appeared to be significantly associated with colonization in the neonates, including use of ventilation, presence of central venous catheters, use of parenteral nutrition, and use of antibacterial or antifungal drugs. However, when the data were analyzed by multivariate logistic regression to control for confounding variables, only gestational age and length of stay on the unit were found to be significantly associated with colonization. CONCLUSION Colonization of infants is not as unusual as previously thought and many infants have established a cutaneous Malassezia commensal flora by the age of 3 to 6 months. Factors that predispose to colonization in neonates may not be the same as those that predispose to infection.
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Affiliation(s)
- H Ruth Ashbee
- Mycology Reference Center, Division of Microbiology, University of Leeds, UK
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Juncosa Morros T, González-Cuevas A, Alayeto Ortega J, Muñoz Almagro C, Moreno Hernando J, Gené Giralt A, Latorre Otín C. Colonización cutánea neonatal por Malassezia spp. An Pediatr (Barc) 2002. [DOI: 10.1016/s1695-4033(02)77964-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Abstract
Malassezia species are members of the human cutaneous commensal flora, in addition to causing a wide range of cutaneous and systemic diseases in suitably predisposed individuals. Studies examining cellular and humoral immune responses specific to Malassezia species in patients with Malassezia-associated diseases and healthy controls have generally been unable to define significant differences in their immune response. The use of varied antigenic preparations and strains from different Malassezia classifications may partly be responsible for this, although these problems can now be overcome by using techniques based on recent work defining some important antigens and also a new taxonomy for the genus. The finding that the genus Malassezia is immunomodulatory is important in understanding its ability to cause disease. Stimulation of the reticuloendothelial system and activation of the complement cascade contrasts with its ability to suppress cytokine release and downregulate phagocytic uptake and killing. The lipid-rich layer around the yeast appears to be pivotal in this alteration of phenotype. Defining the nonspecific immune response to Malassezia species and the way in which the organisms modulate it may well be the key to understanding how Malassezia species can exist as both commensals and pathogens.
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Affiliation(s)
- H Ruth Ashbee
- Mycology Reference Centre, Division of Microbiology, University of Leeds and Leeds General Infirmary, Leeds, United Kingdom.
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KESAVAN S, WALTERS CE, HOLLAND KT, INGHAM E. The effects of Malassezia on pro-inflammatory cytokine production by human peripheral blood mononuclear cells in vitro. Med Mycol 1998. [DOI: 10.1046/j.1365-280x.1998.00137.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kesavan S, Walters C, Holland K, Ingham E. The effects ofMalasseziaon pro-inflammatory cytokine production by human peripheral blood mononuclear cellsin vitro. Med Mycol 1998. [DOI: 10.1080/02681219880000161] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Shattuck KE, Cochran CK, Zabransky RJ, Pasarell L, Davis JC, Malloy MH. Colonization and infection associated with Malassezia and Candida species in a neonatal unit. J Hosp Infect 1996; 34:123-9. [PMID: 8910754 DOI: 10.1016/s0195-6701(96)90137-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The objectives of this study were to determine, in neonates of < 1250 g birthweight (N = 57), the initial time of skin colonization by Malassezia furfur, rate of colonization by Candida spp., and whether skin colonization by these yeasts was predictive of central line colonization or fungaemia. By age two weeks, 51% of neonates were culture-positive for M. furfur on umbilical or groin skin. During hospitalization, positive skin cultures for M. furfur or Candida spp. were obtained in 70% and 37% of neonates, respectively. Risk factors associated with positive skin cultures were mechanical ventilation and three or more episodes of suspected sepsis. Eight of the 52 infants with central venous catheters, had positive blood cultures withdrawn from the lines; five (62%) of these had positive skin surveillance cultures. Although positive skin cultures for M. furfur, Candida spp., or both were commonly observed in this population, they were not predictive of positive central line cultures or systemic illness.
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Affiliation(s)
- K E Shattuck
- Department of Pediatrics, University of Texas Medical Branch, Galveston 77555-0526, USA
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Boekhout T, Bosboom RW. Karyotyping of Malassezia Yeasts: Taxonomic and Epidemiological Implications. Syst Appl Microbiol 1994. [DOI: 10.1016/s0723-2020(11)80043-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Boekhout T, Renting M, Scheffers WA, Bosboom R. The use of karyotyping in the systematics of yeasts. Antonie Van Leeuwenhoek 1993; 63:157-63. [PMID: 8259832 DOI: 10.1007/bf00872390] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The use of electrophoretic karyotyping in systematics of yeasts is discussed. New data are provided on the karyotypes of the medically important fungi Hortaea werneckii, Filobasidiella (= Cryptococcus) neoformans, and Malassezia species. Hortaea werneckii has twelve to eighteen bands of chromosomal DNA, ranging in size between 500 and 2300 kb. The karyotypes of Filobasidiella neoformans consist of seven to fourteen bands of chromosomal DNA. The varieties neoformans and bacillispora cannot be separated by their karyotypes, and no obvious correlation was found with serotypes, geography or habitat. All strains of Malassezia pachydermatis studied have similar karyotypes consisting of five bands, whereas in M. furfur, four different karyotypes are prevalent. However, each of these karyotypes is stable.
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Affiliation(s)
- T Boekhout
- CBS Yeast Division, Delft, The Netherlands
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Ormälä T, Korppi M, Katila ML, Ojanen T, Heinonen K. Fungal gut colonization with Candida or Pityrosporum sp. and serum Candida antigen in preterm neonates with very low birth weights. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1992; 24:781-5. [PMID: 1287812 DOI: 10.3109/00365549209062464] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
To evaluate the diagnostic value of gut colonization by yeasts and of candida antigen in serum for predicting fungal infection in very premature neonates, faecal and serum samples were obtained biweekly from 27 newborn babies treated at our neonatal intensive care unit. Altogether 82 sets of serum and faecal samples were obtained. 17 babies were followed for > or = 4 weeks. Blood cultures, both by routine and lysis centrifugation techniques, were performed for bacteria and fungi if infection was suspected. All children were given systemic broad-spectrum antibiotic treatment. Five of the children died, all without evidence of fungal infection. No systemic antifungal treatments were given. Quantitative faecal cultures demonstrated Candida albicans in 3 (11%) (10(3)-10(5) colony forming units/g) and Pityrosporum sp. in 8 (30%) of the preterm neonates. Candida antigen in titre 4 was detected in 1/82 serum samples. The child subsequently died with no other evidence of candida infection. In 56 full term neonates treated at the intensive care unit during the same period and tested by 1 set of samples, faecal colonization with Candida sp. was detected in 2 (4%) and with Pityrosporum sp. in 4 (15%). None were positive for candida antigen. Fungal gut colonization did not lead to clinical infection in the preterm neonates studied. The false positivity rate of the candida antigen test was low (0.7%). The predictive value of the test could not be determined in this study group with no systemic fungal infections. The role of pityrosporum as an inducer of neonatal infections remains to be evaluated.
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Affiliation(s)
- T Ormälä
- Department of Paediatrics, Kuopio University Hospital, Finland
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