TABLE 13.

Immunological deficiencies in neonates that contribute to their predisposition to systemic Malassezia infections

Immune mechanismDefectReference(s)
Physical barriersSkin thin and easily damaged122
Skin further disrupted by use of monitoring devices and catheters
Lack of, or limited, commensal cutaneous flora218
PhagocytosisNeutrophils functionally impaired76
Neutrophil killing impaired in presence of other diseases, including respiratory distress syndrome and meconium aspiration pneumonia475
Neutrophils from premature neonates
    contain less myeloperoxidase361
    produce less reactive oxygen species16
    have reduced adherence and chemotaxis42
Complement proteinsLevels lower in premature neonates317
Reduced opsonic activity due to decreased levels
Antibody productionLack of maternal IgG transfer to premature neonates
Inability to produce IgM and IgA
Shortened IgG half-life239
Cellular immunityT cells from neonates have
    reduced mitogenic responses78
    low expression of HLA-DR antigens484
    decreased IFN-γ production456
Cellular cytotoxicity impaired3, 163