Benjamin Daniel K, Garges Harmony, Steinbach William J
Department of Pediatrics, Duke University, Durham, NC, USA.
Semin Perinatol. 2003 Oct;27(5):375-83. doi: 10.1016/s0146-0005(03)00061-2.
Neonatal candidemia is poorly understood and is a leading cause of nosocomial infectious mortality in the nursery. Prevention of candidemia has been difficult, although a combined approach of antifungal prophylaxis and targeted empirical therapy may eventually reduce morbidity and mortality. Multicenter prospective testing of an integrated approach to early diagnosis of neonatal candidemia using newer molecular techniques is also needed. Candidemia in the infant is cause for prompt removal (or replacement) of central vascular catheters and institution of antifungal therapy. End-organ evaluation is also probably warranted to guide treatment and facilitate prognostication. Given the continuing progress in clinical research infrastructure and development of new diagnostic tests and antifungal agents, substantial improvement in the prevention, diagnosis, and management of neonatal candidemia is plausible over the next decade.
新生儿念珠菌血症的情况目前了解甚少，是新生儿重症监护室医院感染死亡的主要原因。尽管抗真菌预防和针对性经验性治疗相结合的方法最终可能降低发病率和死亡率，但预防念珠菌血症一直很困难。还需要采用更新的分子技术对新生儿念珠菌血症早期诊断的综合方法进行多中心前瞻性测试。婴儿发生念珠菌血症时，需要及时拔除（或更换）中心静脉导管并开始抗真菌治疗。可能也有必要进行终末器官评估，以指导治疗并促进预后判断。鉴于临床研究基础设施不断进步以及新诊断测试和抗真菌药物的开发，未来十年新生儿念珠菌血症的预防、诊断和管理有望取得实质性改善。
