真菌和细菌败血症与极低出生体重早产儿的阈值性视网膜病变
Fungal and bacterial sepsis and threshold ROP in preterm very low birth weight neonates.
作者信息
Manzoni P, Maestri A, Leonessa M, Mostert M, Farina D, Gomirato G
机构信息
Neonatology and Hospital NICU, Azienda Ospedaliera OIRM - Sant'Anna, and Department of Paediatric Sciences, University of Torino, Italy.
出版信息
J Perinatol. 2006 Jan 1;26(1):23-30. doi: 10.1038/sj.jp.7211420.
OBJECTIVE
To determine whether an association exists between either fungal or bacterial sepsis and retinopathy of prematurity (ROP).
STUDY DESIGN
Retrospective cohort study on all neonates with birth weight <1500 g admitted to a large Italian third Level Neonatal Intensive Care Unit in the years 1997-2001 and screened for ROP. Univariate analysis and multiple logistic regression were used to detect significant associations with ROP (all grades and threshold) in neonates with birth weight<1000 g (extremely low birth weight (ELBW)) and 1000-1500 g.
RESULTS
Among 301 enrolled neonates, ROP (all grades), threshold ROP, fungal and bacterial sepsis occurred in 31.9, 12.9, 11.6 and 40.5% of the infants, respectively. At multivariate analysis, only gestational age (P=0.03), colonization by Candida non-albicans spp (P=0.03) and fungal sepsis (P=0.03) were independent predictors of threshold ROP, and only in ELBW neonates.
CONCLUSIONS
Fungal (but not bacterial) sepsis is significantly and independently associated with ROP, but only in ELBW neonates and only with threshold ROP.
目的
确定真菌性或细菌性败血症与早产儿视网膜病变（ROP）之间是否存在关联。
研究设计
对1997 - 2001年间入住意大利一家大型三级新生儿重症监护病房、出生体重<1500 g且接受ROP筛查的所有新生儿进行回顾性队列研究。采用单因素分析和多因素逻辑回归分析，以检测出生体重<1000 g（极低出生体重（ELBW））和1000 - 1500 g的新生儿中与ROP（所有级别和阈值ROP）的显著关联。
结果
在301名纳入研究的新生儿中，ROP（所有级别）、阈值ROP、真菌性和细菌性败血症的发生率分别为31.9%、12.9%、11.6%和40.5%。多因素分析显示，仅胎龄（P = 0.03）、非白色念珠菌属定植（P = 0.03）和真菌性败血症（P = 0.03）是阈值ROP的独立预测因素，且仅在ELBW新生儿中如此。
结论
真菌性（而非细菌性）败血症与ROP显著且独立相关，但仅在ELBW新生儿中，且仅与阈值ROP相关。
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