Altuncu Emel, Bilgen Hulya, Soysal Ahmet, Ozek Eren
Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Marmara University, 34890 Istanbul, Turkey.
Division of Pediatric Infectious Disease, Department of Pediatrics, Faculty of Medicine, Marmara University, 34890 Istanbul, Turkey.
Case Rep Pediatr. 2015;2015:402137. doi: 10.1155/2015/402137. Epub 2015 Jun 4.
Herein, we report two preterms with invasive candidiasis refractory to liposomal amphotericin B (AMB) treatment in spite of low MIC levels (MIC: 0.5 mcg/mL). Both of the patients' blood cultures were persistently positive for C. parapsilosis despite high therapeutic doses (AMB: 7 mg/kg per day). After starting voriconazole blood cultures became negative and both of the patients were treated successfully without any side effects. In conclusion, although it is not a standard treatment in neonatal patients, our limited experience with these patients suggests that voriconazole appears to be a safe antifungal agent to be used in critically ill preterm infants with persistent fungemia despite AMB treatment.
在此,我们报告两例尽管最低抑菌浓度(MIC)水平较低(MIC:0.5μg/mL),但对脂质体两性霉素B(AMB)治疗难治的侵袭性念珠菌病早产儿。尽管给予高治疗剂量(AMB:每日7mg/kg),两名患者的血培养中近平滑念珠菌仍持续呈阳性。开始使用伏立康唑后血培养转阴,两名患者均成功治愈且无任何副作用。总之,虽然伏立康唑在新生儿患者中并非标准治疗方法,但我们对这些患者的有限经验表明,对于尽管接受AMB治疗但仍有持续性真菌血症的危重新生儿早产儿,伏立康唑似乎是一种安全的抗真菌药物。