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新生儿和儿童侵袭性真菌感染的流行病学。

Epidemiology of invasive fungal infections in neonates and children.

机构信息

Division of Pediatric Infectious Diseases, Department of Molecular Genetics & Microbiology, Duke University, Durham, NC 27710, USA.

出版信息

Clin Microbiol Infect. 2010 Sep;16(9):1321-7. doi: 10.1111/j.1469-0691.2010.03288.x.

Abstract

Invasive fungal infections are major causes of morbidity and mortality in neonates and in both immunocompromised and immunocompetent children. Although these infections have been well characterized in adults, the incidence and analysis of risk factors, diagnostic tools, treatments and outcomes have not been well described for large cohorts of paediatric or neonatal patients. Paediatric exclusion has limited our knowledge of the epidemiology and pathophysiology of paediatric fungal disease, and has also resulted in a paucity of data regarding the safety and efficacy of paediatric antifungal therapy. Previous paediatric cooperative models in other disciplines have successfully advanced our understanding and treatments of childhood diseases, but in the past there has not been a similar organization for paediatric invasive fungal infections. Although there are numerous other reviews outlining the differences in paediatric antifungal dosing pharmacokinetics, there are only smaller epidemiological reports depicting the exact distribution and outcomes of paediatric invasive fungal infections treated with these antifungals. This review will highlight some of the available epidemiological data on paediatric invasive fungal infections.

摘要

侵袭性真菌感染是新生儿以及免疫功能低下和免疫功能正常儿童发病和死亡的主要原因。尽管这些感染在成人中已得到很好的描述,但对于大量儿科或新生儿患者,其发病率和危险因素分析、诊断工具、治疗方法和结局尚未得到很好的描述。儿科人群的排除限制了我们对儿科真菌感染的流行病学和发病机制的了解,也导致了关于儿科抗真菌治疗的安全性和疗效的数据不足。过去在其他学科中的儿科合作模式成功地提高了我们对儿童疾病的认识和治疗水平,但过去并没有针对儿科侵袭性真菌感染的类似组织。虽然有许多其他综述概述了儿科抗真菌药物剂量药代动力学的差异,但只有少数流行病学报告描述了用这些抗真菌药物治疗的儿科侵袭性真菌感染的确切分布和结局。这篇综述将重点介绍一些关于儿科侵袭性真菌感染的现有流行病学数据。

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