Juyal Deepak, Sharma Munesh, Pal Shekhar, Rathaur Vyas Kumar, Sharma Neelam
Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute, Srinagar Garhwal, Uttarakhand, India.
N Am J Med Sci. 2013 Sep;5(9):541-5. doi: 10.4103/1947-2714.118919.
Candida species are one of the most common causes of blood stream infections among neonates and account for 9-13% of such infections. Although Candida albicans remains the most common fungal isolate from neonatal candidemia, longitudinal studies have detected a shift towards non-albicans Candida (NAC) species.
To examine the prevalence and epidemiology of candidemia among infants admitted to our hospital.
Blood samples were collected from 548 neonates and only those which yielded pure growth of Candida spp. were included in the study. The isolates were identified as per standard mycological techniques and antifungal susceptibility (AFS) was done by disc diffusion method.
Of the total 132 neonates included in the study, NAC species were responsible for 80.30% cases with C. parapsilosis (25.0%) and C. tropicalis (21.97%) as the most predominant species; whereas 19.70% of cases were caused by C. albicans. AFS results revealed that 65.91, 73.49, and 96.21% isolates were sensitive to fluconazole (FLK), itraconazole (ITR), and amphotericin B (AMB), respectively.
Candidemia in neonates is an ominous prognostic sign and is an important entity in our hospital. Strict infection control strategies, appropriate preventive and therapeutic measures such as prophylactic antifungal use and a restrictive policy of antibiotic use should be implemented.
念珠菌属是新生儿血流感染最常见的病因之一,占此类感染的9% - 13%。虽然白色念珠菌仍然是新生儿念珠菌血症最常见的真菌分离株,但纵向研究已发现向非白色念珠菌(NAC)菌种的转变。
研究我院收治婴儿念珠菌血症的患病率及流行病学特征。
采集548例新生儿的血样,仅将念珠菌属纯培养阳性的样本纳入研究。按照标准真菌学技术鉴定分离株,并采用纸片扩散法进行抗真菌药敏试验(AFS)。
在纳入研究的132例新生儿中,NAC菌种导致了80.30%的病例,其中近平滑念珠菌(25.0%)和热带念珠菌(21.97%)为最主要菌种;而白色念珠菌导致了19.70%的病例。AFS结果显示,分别有65.91%、73.49%和96.21%的分离株对氟康唑(FLK)、伊曲康唑(ITR)和两性霉素B(AMB)敏感。
新生儿念珠菌血症是一个不祥的预后征象,在我院是一个重要问题。应实施严格的感染控制策略、适当的预防和治疗措施,如预防性使用抗真菌药物和抗生素使用的限制性政策。