title: Fluconazole treatment of intrauterine Candida albicans infection in fetal sheep.
abstract: BACKGROUND
  Intrauterine Candida albicans infection causes severe fetal inflammatory responses and fetal injury in an ovine model. We hypothesized that intra-amniotic antifungal therapy with fluconazole would decrease the adverse fetal effects of intra-amniotic C. albicans in sheep.
  
  
  METHODS
  Sheep received an intra-amniotic injection of 10(7) colony-forming units C. albicans. After 2 d, animals were then randomized to: (i) intra-amniotic and fetal intraperitoneal saline with delivery after 24 h (3 d C. albicans group); (ii) intra-amniotic and fetal intraperitoneal injections of fluconazole with delivery after either 24 h (3 d C. albicans plus 1 d fluconazole group) or 72 h (5 d C. albicans plus 3 d fluconazole group). Controls received intra-amniotic injections of saline followed by intra-amniotic and fetal intraperitoneal fluconazole injections.
  
  
  RESULTS
  Intra-amniotic C. albicans caused severe fetal inflammatory responses characterized by decreases in lymphocytes and platelets, an increase in posterior mediastinal lymph node weight and proinflammatory mRNA responses in the fetal lung, liver, and spleen. Fluconazole treatment temporarily decreased the pulmonary and chorioamnion inflammatory responses.
  
  
  CONCLUSIONS
  The severe fetal inflammatory responses caused by intra-amniotic C. albicans infection were transiently decreased with fluconazole. A timely fetal delivery of antimicrobial agents may prevent fetal injury associated with intrauterine infection.
authors.affiliation: 1] Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, Ohio [2] Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Gunlawadee
authors.initials: G
authors.lastname: Maneenil
authors.affiliation: School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Payne
authors.affiliation: Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, Ohio.
authors.forename: Paranthaman
authors.identifier: 0000000233333720
authors.initials: P
authors.lastname: Senthamarai Kannan
authors.affiliation: 1] Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, Ohio [2] School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
authors.forename: Suhas G
authors.initials: SG
authors.lastname: Kallapur
authors.affiliation: 1] School of Women's and Infants' Health, The University of Western Australia, Perth, Australia [2] Department of Pediatrics, School of Oncology and Development Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Boris W
authors.initials: BW
authors.lastname: Kramer
authors.affiliation: School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
authors.forename: John P
authors.initials: JP
authors.lastname: Newnham
authors.affiliation: School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Miura
authors.affiliation: 1] Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, Ohio [2] School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Jobe
authors.affiliation: School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Kemp
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005315:Fetal Diseases / Q000188:drug therapy* / Q000382:microbiology*; D015725:Fluconazole / Q000627:therapeutic use*; D006652:Histological Techniques; D007249:Inflammation / Q000188:drug therapy* / Q000473:pathology; D011247:Pregnancy; D012756:Sheep
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole