Royal Aberdeen Children's Hospital, Aberdeen, UK.
Royal Aberdeen Children's Hospital, Aberdeen, UK; MRC Centre for Medical Mycology, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
J Infect. 2017 Jun;74 Suppl 1:S108-S113. doi: 10.1016/S0163-4453(17)30200-1.
Fungal infections largely caused by Candida species are responsible for a significant disease burden in neonates and invasive candidiasis in hospitalised neonates has high associated morbidity and mortality. Early initiation of antifungal treatment improves outcome but the recognition and diagnosis of systemic fungal infection in this population is difficult due to the non-specific clinical presentation and the high false negative rate of cultures. There is a need for a practical, sensitive and rapid diagnostic test to enhance identification and early treatment. Serum detection of (1,3)-β-d-glucan and Candida PCR are promising candidates but at present limited data exists for their use in the neonatal intensive care setting. Until such investigations are validated, early initiation of antifungal treatment on the basis of risk factor profile and clinical features remains the safest practical approach.
真菌感染主要由念珠菌引起，给新生儿带来了沉重的疾病负担，住院新生儿侵袭性念珠菌病发病率高，死亡率高。早期开始抗真菌治疗可改善预后，但由于临床表现非特异性和培养假阴性率高，该人群中系统性真菌感染的识别和诊断较为困难。因此，需要一种实用、敏感、快速的诊断试验来提高识别和早期治疗的效果。（1,3）-β-d-葡聚糖和念珠菌 PCR 的血清检测是很有前途的候选方法，但目前在新生儿重症监护环境中使用这些方法的数据有限。在这些研究得到验证之前，根据危险因素谱和临床特征尽早开始抗真菌治疗仍然是最安全的实用方法。
