Reduced lymphocyte-mediated antifungal capacity in high-risk infants.

Premature and critically ill infants are highly susceptible to Candida albicans. This study evaluated the lymphocyte-mediated antifungal capacity of infants relative to birth weight, prematurity, and illness severity. Growth inhibition of C. albicans by lymphocytes from preterm and low-birth weight infants was significantly reduced, compared with full-term and normal-weight infants. Lymphocyte growth inhibition of C. albicans is dependent on cell adhesion to the fungus. Compared with full-term infants, lymphocytes from preterm infants had a reduced capacity to adhere to C. albicans. Furthermore, infants with greater severity of illness (score for neonatal acute physiology [SNAP], >or=10) exhibited significantly reduced lymphocyte-mediated antifungal capacity and fungal adhesion. Although gestational age, birth weight, and SNAP were significantly associated with lymphocyte-mediated growth inhibition and adhesion, stepwise regression analysis demonstrated that gestational age best predicted both lymphocyte growth inhibition of and adhesion to the fungus.