Universität zu Köln

Mehler, Katrin, Cornely, Oliver, Seifert, Harald, Zweigner, Janine, Janssen, Saskia and Oberthuer, Andre (2022). Molds and More: Rare Fungal Infections in Preterm Infants <24 Weeks of Gestation. Pediatr. Infect. Dis. J., 41 (4). S. 352 - 358. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1532-0987

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Abstract

Background: Extreme immature infants are at an increased risk of fungal infection due to immaturity of the skin barrier and the immune system. Besides Candida infections, in particular, Aspergillus may cause life-threatening diseases in preterm infants. Frequently, Aspergillus primarily affects the skin and may cause extensive damage. Methods: We searched our hospital database for fungal infections other than Candida in preterm infants treated between 2015 and 2020 at our level III neonatal intensive care unit of the University Hospital of Cologne. Results: In total, 13 preterm infants were identified. Of these, 11 had cutaneous Aspergillosis, one infant had severe enterocolitis caused by Aspergillus and Rhizopus and one had invasive intraabdominal Trichosporon mucoides infection. All infants were born <24 weeks of gestation, were delivered due to premature labor or chorioamnionitis, and had received prenatal steroids and/or hydrocortisone. Voriconazole and liposomal Amphotericin B were first-line treatments and the length of treatment varied between 3 and 148 days. Two infants died associated with severe infection. Liver toxicity was observed in six infants treated with Voriconazole. Therapeutic drug management for Voriconazole was performed in four infants. Target levels were not achieved by the doses that are recommended. Conclusions: Rare fungal infections, predominantly cutaneous Aspergillosis affects the most immature preterm infants and may cause severe disease. Treatment with Voriconazole has a high rate of liver toxicity and target levels are difficult to achieve in extremely immature infants.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mehler, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Zweigner, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Janssen, Saskia UNSPECIFIED UNSPECIFIED UNSPECIFIED Oberthuer, Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-662479
DOI:	10.1097/INF.0000000000003407
Journal or Publication Title:	Pediatr. Infect. Dis. J.
Volume:	41
Number:	4
Page Range:	S. 352 - 358
Date:	2022
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1532-0987
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CUTANEOUS ASPERGILLOSIS; AMPHOTERICIN-B; VORICONAZOLE; CHILDREN; CLUSTER Multiple languages Immunology; Infectious Diseases; Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66247