Sokou Rozeta, Palioura Alexia Eleftheria, Kopanou Taliaka Paschalia, Konstantinidi Aikaterini, Tsantes Andreas G, Piovani Daniele, Tsante Konstantina A, Gounari Eleni A, Iliodromiti Zoi, Boutsikou Theodora, Tsantes Argirios E, Bonovas Stefanos, Iacovidou Nicoletta
Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, 18454 Piraeus, Greece.
Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece.
J Clin Med. 2024 Mar 10;13(6):1586. doi: 10.3390/jcm13061586.
(1) In recent years, a global epidemiological shift in candidemia has been observed, marked by the emergence of resistant non-albicans Candida species. , in particular, has become a significant global concern, causing infections in both pediatric and adult populations within healthcare settings. Despite its widespread impact, there is a limited understanding of the clinical course and transmission dynamics of neonatal systemic Candida auris infections, hindering effective prevention and management. This study focused on the epidemiologic data, the clinical presentation, risk factors, and outcome of infection in neonatal population. (2) : A systematic review of the literature using PubMed and Scopus databases until December 2023 was conducted. (3) : A total of 24 relevant studies were identified, encompassing 476 documented cases of infection in neonates. Prematurity emerged as a primary risk factor, alongside total parenteral nutrition, central line insertion, mechanical ventilation, and prior broad-spectrum antibiotic use. The mortality rate reached approximately 42%, with therapeutic details sparingly reported in 12% of cases. Treatment strategies varied, with amphotericin B predominantly used as monotherapy, while combination antifungal agents were used in 44% of cases. Notably, 97.4% of cases exhibited fluconazole resistance, and 67.1% showed resistance to amphotericin B. Limited data were available on resistance to other antifungal agents. (4) : Despite the rarity of neonatal infections, their global occurrence necessitates comprehensive preparedness in patient care. A deeper understanding of pathogenesis is crucial for developing effective strategies to control and prevent neonatal infections caused by this pathogen.
(1) 近年来，观察到全球范围内念珠菌血症的流行病学发生了转变，其特征是耐药非白色念珠菌物种的出现。耳念珠菌尤其已成为全球重大关注问题，在医疗机构的儿科和成人人群中均引发感染。尽管其影响广泛，但对新生儿系统性耳念珠菌感染的临床病程和传播动态了解有限，这阻碍了有效的预防和管理。本研究聚焦于新生儿人群中耳念珠菌感染的流行病学数据、临床表现、危险因素及结局。(2) 方法：使用PubMed和Scopus数据库对截至2023年12月的文献进行系统综述。(3) 结果：共确定了24项相关研究，涵盖476例记录在案的新生儿耳念珠菌感染病例。早产成为主要危险因素，此外还有全胃肠外营养、中心静脉置管、机械通气及先前使用广谱抗生素。死亡率约达42%，仅12%的病例有少量治疗细节报告。治疗策略各异，两性霉素B主要用作单一疗法，44%的病例使用联合抗真菌药物。值得注意的是，97.4%的病例对氟康唑耐药，67.1%的病例对两性霉素B耐药。关于对其他抗真菌药物耐药性的数据有限。(4) 结论：尽管新生儿耳念珠菌感染罕见，但其在全球的出现要求在患者护理方面做好全面准备。深入了解耳念珠菌发病机制对于制定有效策略控制和预防该病原体引起的新生儿感染至关重要。
