Section of Neonatology, Department of Pediatrics, Texas Children's Hospital & Baylor College of Medicine, Houston, TX, USA.
Expert Rev Anti Infect Ther. 2013 Jul;11(7):709-21. doi: 10.1586/14787210.2013.811925. Epub 2013 Jul 5.
Invasive fungal infections due to Candida are the third most common late-onset infection in infants born with birth weight <1500 g. Invasive candidiasis in infants born with birth weight <1000 g is associated with a 30% mortality and with neurodevelopmental impairment in more than half the survivors. A high degree of suspicion and a thorough multisystem evaluation is necessary for diagnosis of invasive fungal infections and to detect complications or sequalae. Amphotericin B deoxycholate is the mainstay in the treatment of invasive fungal infections in newborns. Early initiation of enteral feeds with human milk, decreasing dependence on catheters and avoidance of antacids, steroids and broad-spectrum antibiotics are the recommended preventive measures. Fluconazole prophylaxis should be targeted towards neonates born with <1000 g in neonatal units where baseline rates of invasive candidiasis are more than 5%.
由念珠菌引起的侵袭性真菌感染是出生体重<1500g 的婴儿中第三大常见的迟发性感染。出生体重<1000g 的婴儿侵袭性念珠菌病与 30%的死亡率相关，且超过一半的幸存者存在神经发育损伤。高度怀疑和彻底的多系统评估对于侵袭性真菌感染的诊断以及发现并发症或后遗症是必要的。两性霉素 B 去氧胆酸盐是新生儿侵袭性真菌感染治疗的基础。早期开始用母乳喂养，减少对导管的依赖，并避免使用抗酸剂、类固醇和广谱抗生素，这些是推荐的预防措施。氟康唑预防应针对出生体重<1000g 的新生儿，且在侵袭性念珠菌病基线率>5%的新生儿病房中进行。
