TABLE 13.

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

Immune mechanismDefectReference(s)
Physical barriersSkin thin and easily damaged 122
Skin further disrupted by use of monitoring devices and catheters
Lack of, or limited, commensal cutaneous flora 218
PhagocytosisNeutrophils functionally impaired 76
Neutrophil killing impaired in presence of other diseases, including respiratory distress syndrome and meconium aspiration pneumonia 475
Neutrophils from premature neonates
    contain less myeloperoxidase 361
    produce less reactive oxygen species 16
    have reduced adherence and chemotaxis 42
Complement proteinsLevels lower in premature neonates 317
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-life 239
Cellular immunityT cells from neonates have
    reduced mitogenic responses 78
    low expression of HLA-DR antigens 484
    decreased IFN-γ production 456
Cellular cytotoxicity impaired 3, 163