Candida virulence properties and adverse clinical outcomes in neonatal candidiasis.

Journal Article (Journal Article)

OBJECTIVE: To determine whether premature infants with invasive Candida infection caused by strains with increased virulence properties have worse clinical outcomes than those infected with less virulent strains. STUDY DESIGN: Clinical isolates were studied from 2 populations of premature infants, those colonized with Candida spp (commensal; n = 27) and those with invasive candidiasis (n = 81). Individual isolates of C albicans and C parapsilosis were tested for virulence in 3 assays: phenotypic switching, adhesion, and cytotoxicity. Invasive isolates were considered to have enhanced virulence if detected at a level >1 SD above the mean for the commensal isolates in at least one assay. Outcomes of patients with invasive isolates with enhanced virulence were compared with those with invasive isolates lacking enhanced virulence characteristics. RESULTS: Enhanced virulence was detected in 61% of invasive isolates of C albicans and 42% of invasive isolates of C parapsilosis. All C albicans cerebrospinal fluid isolates (n = 6) and 90% of urine isolates (n = 10) had enhanced virulence, compared with 48% of blood isolates (n = 40). Infants with more virulent isolates were younger at the time of positive culture and had higher serum creatinine levels. CONCLUSION: Individual isolates of Candida species vary in their virulence properties. Strains with higher virulence are associated with certain clinical outcomes.

Full Text

Duke Authors

Cited Authors

  • Bliss, JM; Wong, AY; Bhak, G; Laforce-Nesbitt, SS; Taylor, S; Tan, S; Stoll, BJ; Higgins, RD; Shankaran, S; Benjamin, DK; Candida Subcommittee of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network,

Published Date

  • September 2012

Published In

Volume / Issue

  • 161 / 3

Start / End Page

  • 441 - 447.e2

PubMed ID

  • 22504098

Pubmed Central ID

  • PMC3419788

Electronic International Standard Serial Number (EISSN)

  • 1097-6833

Digital Object Identifier (DOI)

  • 10.1016/j.jpeds.2012.02.051


  • eng

Conference Location

  • United States