Baley J E, Kliegman R M, Boxerbaum B, Fanaroff A A
Pediatrics. 1986 Aug;78(2):225-32.
In the neonate, fungal infections result in significant morbidity and mortality. For very low birth weight (less than 1,500 g) infants, we prospectively determined the fungal colonization rate to be 26.7%. In one third of infants with fungal colonies, mucocutaneous candidiasis developed, and in 7.7%, systemic disease developed. Two thirds of the infants had colonies in the first week of life. This colonization was probably acquired during labor and delivery, because those infants who had colonization were more often delivered vaginally than by cesarean section. Early colonization, commonly from the gastrointestinal or respiratory tract, featured Candida albicans and Candida tropicalis. Late colonization, occurring after 2 weeks of life (15.0% of patients), was more likely to be cutaneous and was associated with either Candida parapsilosis or such poor growth that the organism could not be identified. Infants with colonization only rarely had budding yeasts (6.1%), whereas more than half of the infants with either a urinalysis showing budding yeasts or a urine culture growing fungi had invasive disease. Fungal contamination was not found on either thoracotomy tubes or catheter tips. In the low birth weight infant, fungal colonization represents a significant risk factor for cutaneous or systemic candidiasis in these infants.
在新生儿中，真菌感染会导致显著的发病率和死亡率。对于极低出生体重（低于1500克）的婴儿，我们前瞻性地确定真菌定植率为26.7%。在有真菌菌落的婴儿中，三分之一发生了黏膜皮肤念珠菌病，7.7%发生了全身性疾病。三分之二的婴儿在出生第一周就有菌落。这种定植可能是在分娩过程中获得的，因为有定植的婴儿经阴道分娩的比例高于剖宫产。早期定植通常来自胃肠道或呼吸道，以白色念珠菌和热带念珠菌为主。晚期定植发生在出生2周后（占患者的15.0%），更可能是皮肤定植，与近平滑念珠菌有关，或者生长情况太差以至于无法鉴定出该微生物。仅有定植的婴儿很少有芽生酵母菌（6.1%），而尿液分析显示有芽生酵母菌或尿培养有真菌生长的婴儿中，超过一半患有侵袭性疾病。在开胸管或导管尖端未发现真菌污染。在低出生体重婴儿中，真菌定植是这些婴儿发生皮肤或全身性念珠菌病的一个重要危险因素。
