Smith H, Congdon P
Arch Dis Child. 1985 Apr;60(4):365-9. doi: 10.1136/adc.60.4.365.
Ten babies who required neonatal intensive care developed systemic candidiasis. Eight were extremely preterm (28 weeks' gestation or less) and all received prolonged ventilation, multiple courses of broad spectrum antibiotics, and intravenous hyperalimentation. Diagnosis was established by culture of yeasts from suprapubic urine specimens; venous blood cultures proved unreliable. Initial treatment with 5-flucytosine alone in eight babies and combined with amphotericin B in two, eradicated the infection in nine babies, the treatment failure arising through diagnostic delay and development of resistance to 5-flucytosine. Prophylactic topical antifungal drugs, regular screening of suprapubic urine specimens, and prompt use of systemic antifungal agents before multifocal infection becomes established may reduce the incidence and improve outcome.
十名需要新生儿重症监护的婴儿发生了全身性念珠菌病。其中八名是极早产儿（妊娠28周或更短），均接受了长时间通气、多疗程广谱抗生素治疗以及静脉高营养治疗。通过耻骨上尿液标本培养出酵母菌确诊；静脉血培养结果不可靠。八名婴儿最初单独使用5-氟胞嘧啶治疗，两名婴儿联合使用两性霉素B治疗，九名婴儿感染得以根除，治疗失败是由于诊断延误和对5-氟胞嘧啶产生耐药性。预防性局部抗真菌药物、定期筛查耻骨上尿液标本以及在多灶性感染形成之前及时使用全身性抗真菌药物，可能会降低发病率并改善预后。
