Faix R G
Section of Newborn Services, Women's Hospital, Ann Arbor, MI 48109-0254.
Pediatr Infect Dis J. 1992 Feb;11(2):88-93.
Severe infections caused by non-albicans Candida species are being increasingly reported among infants in neonatal intensive care units. To assess relative severity, mortality rates for C. albicans (CA) and C. parapsilosis (CP) infections in one neonatal intensive care unit from 1980 to 1990 were compared. Invasive candidiasis was defined as Candida recovery from a normally sterile body fluid or site with clinical signs of infection. Invasive candidiasis was diagnosed and systemic antifungal therapy initiated in 45 infants, 29 with CA and 16 with CP. No differences were found between CA and CP for birth weight, gestational age, age or weight at onset, presence of necrotizing enterocolitis, gastrointestinal or genitourinary anomalies, death (all causes), prior incidence or duration of antibiotics, parenteral nutrition, steroids or endotracheal intubation. Candida infection as the cause of death was more frequent with CA than CP (7 of 29 vs. 0 of 16; P = 0.034). Infants with CA were more likely to have antecedent thrush (P = 0.007) and perineal Candida dermatitis (P less than 0.02); those with CP were more likely to have vascular catheters at the time of positive culture (P less than 0.02). Though both pathogens occur in similar neonatal intensive care unit infants and can cause severe disease, CA appears more likely to result in death than CP.
新生儿重症监护病房的婴儿中，由非白色念珠菌引起的严重感染报告日益增多。为评估相对严重程度，比较了1980年至1990年期间一个新生儿重症监护病房中白色念珠菌（CA）和近平滑念珠菌（CP）感染的死亡率。侵袭性念珠菌病定义为从通常无菌的体液或部位分离出念珠菌且伴有感染临床体征。45例婴儿被诊断为侵袭性念珠菌病并开始进行全身抗真菌治疗，其中29例为CA感染，16例为CP感染。在出生体重、胎龄、发病时的年龄或体重、坏死性小肠结肠炎的存在、胃肠道或泌尿生殖系统异常、死亡（各种原因）、先前抗生素使用的发生率或持续时间、肠外营养、类固醇或气管插管方面，CA和CP之间未发现差异。CA感染作为死亡原因比CP更常见（29例中的7例 vs. 16例中的0例；P = 0.034）。CA感染的婴儿更易有先前的鹅口疮（P = 0.007）和会阴念珠菌性皮炎（P < 0.02）；CP感染的婴儿在培养阳性时更易有血管导管（P < 0.02）。尽管这两种病原体在相似的新生儿重症监护病房婴儿中均有发生且均可导致严重疾病，但CA似乎比CP更易导致死亡。
