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新生儿重症监护病房侵袭性念珠菌感染:危险因素及预防新见解

Invasive Candida Infections in Neonatal Intensive Care Units: Risk Factors and New Insights in Prevention.

作者信息

Dermitzaki Niki, Baltogianni Maria, Tsekoura Efrosini, Giapros Vasileios

机构信息

Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Paediatric Department, Asklepieion Voula's General Hospital, 16673 Athens, Greece.

出版信息

Pathogens. 2024 Aug 6;13(8):660. doi: 10.3390/pathogens13080660.

Abstract

Invasive Candida infections represent a significant cause of morbidity and mortality in neonatal intensive care units (NICUs), with a particular impact on preterm and low-birth-weight neonates. In addition to prematurity, several predisposing factors for Candida colonization and dissemination during NICU hospitalization have been identified, including prolonged exposure to broad-spectrum antibiotics, central venous catheters, parenteral nutrition, corticosteroids, H2 antagonist administration, and poor adherence to infection control measures. According to the literature, the implementation of antifungal prophylaxis, mainly fluconazole, in high-risk populations has proven to be an effective strategy in reducing the incidence of fungal infections. This review aims to provide an overview of risk factors for invasive Candida infections and current perspectives regarding antifungal prophylaxis use. Recognizing and reducing people's exposure to these modifiable risk factors, in conjunction with the administration of antifungal prophylaxis, has been demonstrated to be an effective method for preventing invasive candidiasis in susceptible neonatal populations.

摘要

侵袭性念珠菌感染是新生儿重症监护病房(NICU)发病和死亡的重要原因,对早产儿和低体重新生儿影响尤为显著。除早产外,已确定了NICU住院期间念珠菌定植和播散的几个易感因素,包括长期使用广谱抗生素、中心静脉导管、肠外营养、皮质类固醇、H2拮抗剂给药以及感染控制措施依从性差。根据文献,在高危人群中实施抗真菌预防,主要是氟康唑,已被证明是降低真菌感染发生率的有效策略。本综述旨在概述侵袭性念珠菌感染的危险因素以及抗真菌预防用药的当前观点。认识并减少人们接触这些可改变的危险因素,同时给予抗真菌预防,已被证明是预防易感新生儿群体侵袭性念珠菌病的有效方法。

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