Belet Nurşen, Ciftçi Ergin, Aysev Derya, Güriz Haluk, Uysal Zümrüt, Taçyildiz Nurdan, Atasay Begüm, Doğu Figen, Kendirli Tanil, Kuloğlu Zarife, Ince Erdal, Doğru Ulker
Department of Pediatric Infectious Diseases, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.
Turk J Pediatr. 2011 Sep-Oct;53(5):489-98.
The aims of the study were to examine the distribution of Candida spp. isolated from sterile body sites, the antifungal susceptibility of the isolates to amphotericin B, fluconazole, voriconazole, and caspofungin, and factors affecting mortality with invasive Candida infections in children. Thirty-five children with invasive candidiasis between January 2004 and January 2008 were evaluated retrospectively. The antifungal susceptibility of isolated Candida species was studied by Etest. Of the invasive Candida infections, 65.7% were due to C. albicans. The second most common isolated species was C. parapsilosis (11.4%). The rates of resistance to fluconazole, amphotericin B and voriconazole were 8.5%, 2.8% and 5.7%, respectively. Caspofungin was the most effective antifungal agent. 22.8% of the patients died in the first 30 days. In univariate analyses, increased mortality was associated with stay in the intensive care unit, the presence of central venous catheter (CVC), failure to remove CVC, and mechanical ventilation.
本研究的目的是检测从无菌身体部位分离出的念珠菌属的分布情况、分离株对两性霉素B、氟康唑、伏立康唑和卡泊芬净的抗真菌药敏性，以及影响儿童侵袭性念珠菌感染死亡率的因素。对2004年1月至2008年1月期间35例侵袭性念珠菌病患儿进行回顾性评估。采用Etest法研究分离出的念珠菌属的抗真菌药敏性。在侵袭性念珠菌感染中，65.7% 由白色念珠菌引起。第二常见的分离菌种是近平滑念珠菌（11.4%）。对氟康唑、两性霉素B和伏立康唑的耐药率分别为8.5%、2.8%和5.7%。卡泊芬净是最有效的抗真菌药物。22.8%的患者在最初30天内死亡。在单因素分析中，死亡率增加与入住重症监护病房、存在中心静脉导管（CVC）、未拔除CVC以及机械通气有关。
