Ben-Ari Josef, Samra Zmira, Nahum Elhanan, Levy Izhak, Ashkenazi Shai, Schonfeld Tommy M
Intensive Care Unit, Dana Children's Hospital, Tel-Aviv Souraski Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Pediatr Crit Care Med. 2006 Mar;7(2):115-8. doi: 10.1097/01.PCC.0000200946.30263.B6.
To determine the efficacy of oral amphotericin B for the prevention of Candida bloodstream infection in the pediatric intensive care unit.
Retrospective, nonrandomized, historic-control study.
Multidisciplinary pediatric intensive care unit at a university-affiliated children's medical center.
Study group included all patients admitted to the pediatric intensive care unit from January 1, 1998, to December 31, 1999, who required mechanical ventilation and who were admitted for >7 days. The control group included all patients admitted for >7 days who needed mechanical ventilation from January 1, 1994, to December 31, 1997.
Oral amphotericin B suspension, 50 mg every 8 hrs, administered to all study group patients soon after initiation of mechanical ventilation and terminating after weaning.
The rates of Candida bloodstream infection were compared between the study and control groups.
Candida species were isolated from blood cultures in 5 of 185 (2.1%) and 21 of 196 (10.7%) patients in the study and control groups, respectively (p= .0038). There was also a statistically significant (p= .017) decrease in Candida bloodstream infection rate in all patients admitted to the pediatric intensive care unit for >7 days during the study period compared with the Candida bloodstream infection rate during the control period.
Prophylactic administration of oral amphotericin B may lead to a significant decrease in the rate of Candida bloodstream infection in ventilated pediatric intensive care unit patients.
确定口服两性霉素B预防儿科重症监护病房念珠菌血流感染的疗效。
回顾性、非随机、历史对照研究。
一所大学附属医院儿童医疗中心的多学科儿科重症监护病房。
研究组包括1998年1月1日至1999年12月31日入住儿科重症监护病房、需要机械通气且住院时间超过7天的所有患者。对照组包括1994年1月1日至1997年12月31日住院时间超过7天且需要机械通气的所有患者。
所有研究组患者在开始机械通气后不久即给予口服两性霉素B混悬液，每8小时50毫克，撤机后停用。
比较研究组和对照组念珠菌血流感染率。
研究组185例患者中有5例（2.1%）、对照组196例患者中有21例（10.7%）血培养分离出念珠菌属（p = 0.0038）。与对照期相比，研究期内入住儿科重症监护病房超过7天的所有患者念珠菌血流感染率也有统计学显著下降（p = 0.017）。
预防性给予口服两性霉素B可能导致通气的儿科重症监护病房患者念珠菌血流感染率显著下降。
