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新生儿侵袭性真菌感染:综述。

Invasive fungal infections in neonates: a review.

机构信息

Division of Neonatology, Department of Pediatrics, Duke University, Durham, NC, UK.

Duke Clinical Research Institute, Durham, NC, UK.

出版信息

Pediatr Res. 2022 Jan;91(2):404-412. doi: 10.1038/s41390-021-01842-7. Epub 2021 Dec 9.

Abstract

Invasive fungal infections remain the leading causes of morbidity and mortality in neonates, especially preterm and very low birth weight infants. Most invasive fungal infections are due to Candida or Aspergillus species, and other fungi are increasingly reported and described. Appropriate identification and treatment are required to augment activity and reduce the toxicity of antifungal drugs. Successful use of antifungals in the vulnerable neonatal population is important for both prevention and treatment of infection. Strategies for prevention, including prophylactic antifungal therapy as well as reducing exposure to modifiable risk factors, like limiting antibiotic exposure, discontinuation of central catheters, and hand hygiene are key techniques to prevent and decrease rates of invasive fungal infections. In conclusion, this is a review of the most common causes, prevention strategies, prophylaxis, and treatment of invasive fungal infections in neonates.

摘要

侵袭性真菌感染仍然是新生儿发病率和死亡率的主要原因,尤其是早产儿和极低出生体重儿。大多数侵袭性真菌感染是由念珠菌或曲霉菌引起的,其他真菌也越来越多地被报道和描述。需要进行适当的鉴定和治疗,以增强抗真菌药物的活性并降低其毒性。在易受侵袭性真菌感染的新生儿人群中成功使用抗真菌药物对于感染的预防和治疗都很重要。预防策略包括预防性抗真菌治疗以及减少接触可改变的危险因素,如限制抗生素暴露、停止使用中心导管和手部卫生,这些都是预防和降低侵袭性真菌感染发生率的关键技术。总之,本文综述了新生儿侵袭性真菌感染的常见病因、预防策略、预防用药和治疗方法。

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