Orozco Paula Andrea, Cortés Jorge Alberto, Parra Claudia Marcela
Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.
Rev Iberoam Micol. 2009 Jun 30;26(2):108-11. doi: 10.1016/S1130-1406(09)70020-8.
Candida infections in the neonatal intensive care unit (NICU) are associated with high morbidity and mortality rates. The main objective of this work was to determine the risk factors for colonization by Candida species in the newborns in a hospital NICU in Bogota, Colombia, and to evaluate the colonization of intravascular devices and healthcare personnel. Fifty newborns at high risk (low birth-weight, gestational age under 35 weeks, previous exposure to antibiotics and eight days of stay in the NICU) were followed prospectively. Clinical specimens from conjunctiva, nasal orifices, oral cavity, inguinal skin, rectum, intravascular devices, and the resulting watery solution of the washing of hands of healthcare personnel were cultured. Samples were cultured on Sabouraud agar with chloramphenicol (50 ppm). Identification of yeasts was peformed using phenotypic and biochemical tests. A multivariate analysis of the risk factors for colonization in the newborns was performed. Growth of different Candida spp. was found in samples recovered from 38% of the newborns tested. However, no yeasts were obtained in cultures from intravascular devices. About 32% of the samples from healthcare personnel (paediatricians, undergraduate and postgraduate students, professional nurses and nurse assistants), showed presence of yeasts. In the multivariate regression analysis length of stay in the NICU was the only identified risk factor for colonization.
新生儿重症监护病房(NICU)中的念珠菌感染与高发病率和死亡率相关。这项工作的主要目的是确定哥伦比亚波哥大一家医院NICU中新生儿念珠菌定植的危险因素,并评估血管内装置和医护人员的定植情况。对50名高危新生儿(低出生体重、胎龄小于35周、既往接触过抗生素且在NICU住院8天)进行了前瞻性随访。对来自结膜、鼻孔、口腔、腹股沟皮肤、直肠、血管内装置的临床标本以及医护人员洗手后的水样溶液进行培养。样本在含氯霉素(50 ppm)的沙氏琼脂上培养。使用表型和生化试验对酵母进行鉴定。对新生儿定植的危险因素进行了多变量分析。在38%接受检测的新生儿样本中发现了不同念珠菌属的生长。然而,在血管内装置培养物中未获得酵母。医护人员(儿科医生、本科和研究生、专业护士和护士助理)约32%的样本显示有酵母存在。在多变量回归分析中,NICU住院时间是唯一确定的定植危险因素。