Bronchoalveolar macrophages (BAM) protect the adult lung from low level microbial contamination. The antimicrobial activity of human newborn BAM is unknown. BAM were isolated from effluents of suctioned, intubated newborns and from bronchoalveolar lavage of healthy, nonsmoking adult volunteers. An in vitro cytologic slide assay was developed and used to ascertain: 1) inhibition of intracellular filamentation of Candida albicans (active yeast growth) and 2) killing + digestion of ingested C. albicans. The ability to restrict intracellular yeast filamentation was markedly different for human newborn versus adult BAM. Adult BAM were five times more effective in restricting intracellular filamentation of Candida compared to newborn cells (p less than 0.01). Nonfilamented ingested yeast were also handled differently by newborn and adult macrophages. Nonfilamented yeast were killed and digested by adult BAM at a rate that was 2.5 times above that noted in neonatal lung macrophages (p less than 0.005). However, no differences were found in the total number of killed + digested Candida within human newborn and adult BAM [adult = 32.4 +/- 10.5% (n = 5), newborn less than 1200 g = 39.6 +/- 16.8% (n = 8), and newborn greater than 1200 g = 30.2 +/- 11.1% (n = 16), mean +/- S.D.]. Neonatal BAM were able to destroy C. albicans at a level equivalent to adult cells because these newborn phagocytes allowed intracellular Candida to enter a state of active growth, thereby rendering the yeast more susceptible to killing and digestion. The anti-Candida activity noted in lung macrophages recovered from normal 1-day-old and adult rabbits was similar to that seen in human BAM.(ABSTRACT TRUNCATED AT 250 WORDS)