Objective To investigate the clinical characteristics and pathogens and risk factors of fungal sepsis in preterm neonates and provide evidence for early diagnosis and treatment. Methods All preterm infants from May 2012 to May 2015 were selected.Pathogens and clinical features were observed and analyzed,and the outcomes were recorded. Results A total of 2 534 cases were admitted.Among the 23 infants diagnosed with positive blood,14 were very low birth weight (VLBW) infants and 5 were extremely low birth (ELBW) infants.Compared with the preterm infants without fungal sepsis,low birth weight,small gestational age,venous catheter and long-term parenteral nutrition were the risk factors.23 cases of fungal sepsis were due to Candidiasis,including 16 (69.6%) Candida parapsilosis,6 (26.1%) Candida albicans,1 (4.3%)Candida nameless.All of the Candidiasis were sensitive to Fluconazole. Conclusion VLBW/ELBW preterm infants are susceptible of fungal septicemia.Venous catheter and long-term parenteral nutrition are the risk factors.The full treatment course can improve the prognosis.
Key words
premature infant /
fungal /
septicemia /
fluconazole
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References
[1] 中华医学会儿科学分会早产儿学组,中华医学会中华儿科杂志编辑委员会.早产儿败血症诊疗方案[J].中华儿科杂志,2003,41(9):897-899.
[2] 邵肖梅,叶鸿瑁,丘小汕.实用早产儿学[M].4版.北京:人民卫生出版社,2011:342.
[3] Advani S,Reich NG,Sengupta A,et al.Central line- associated bloodstream infection in hospitalized children with eripherally inserted central venous catheters:extending risk analyses outside the intensive care unit[J].Clin Infect Dis,2011,52(9):1108-1115.
[4] Brissaud O,Tandonnet O,Guichoux J.Invasive candidiasis in neonatal intensive care units[J].Arch Pediatr,2011,18(Suppl 1):22-32.
[5] Greenberg RG,Benjamin DK Jr,Gantz MG,et al.Empiric antifungal therapy and outcomes in extremely low birth weight infants with nvasive candidiasis [J].J Pediatr,2012,161(2):264-269.
[6] Le J,Tran TT,Bui I,et al.Time to initiation of antifungal therapy for neonatal candidiasis [J].Antimicrob Agents Chemother,2013,57(6):2550-2555.
[7] Benjamin DK Jr,Smith PB,Arrieta A,et al.Safety and pharmacokinetics of repeat-dose micafungin in young infants[J].Clin Pharmacol Ther,2010,87(1):93-99.
[8] Benjamin DK Jr,Hudak ML,Duara S,et al.Effect of fluconazole prophylaxis on candidiasis and mortality in premature infants:a randomized clinical trial[J].JAMA,2014,311 (17):1742-1749.
[9] Pappas PG,Kauffman CA,Andes D,et al.Clinical practice guidelines for the management of candidiasis:2009 update by the Infectious Diseases Society of America[J].Clin Infect Dis,2009,48 (5):503-535.
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