Narang A, Agrawal P B, Chakrabarti A, Kumar P
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Trop Pediatr. 1998 Apr;44(2):104-8. doi: 10.1093/tropej/44.2.104.
143 neonates were diagnosed to have acquired systemic candidiasis out of a total 4530 admissions (3.2 per cent) to the neonatal intensive care unit (NICU) during a period of 6 1/2 years from January 1990 to June 1996. Mean age at onset was 10.4 days, mean birth weight 1454 g, and mean gestation was 31.7 weeks. Ninety-four per cent were premature, 95 per cent low birth weight (LBW), and all had undergone peripheral vein catheterization and had received broad spectrum antibiotics, except one, prior to the diagnosis. Fifty-eight per cent were ventilated and 15 per cent received parenteral nutrition. Persistent/recurrent pneumonia, apnoea, lethargy, high gastric aspirates, and abdominal distension were the common clinical manifestations. Candida tropicalis, C. albicans, and C. guillermondii were the most common isolates. Blood and urine were the predominant sites for isolation of Candida. Fluconazole was the most used antifungal agent, with 24 per cent resistance against it. Fifty per cent of babies died due to all causes. Of all the deaths, two-thirds were Candida related. Candida-attributable deaths occurred in 24 cases (17 per cent).
在1990年1月至1996年6年半的时间里，新生儿重症监护病房（NICU）共收治4530例新生儿，其中143例被诊断为获得性系统性念珠菌病（占3.2%）。发病时的平均年龄为10.4天，平均出生体重为1454克，平均孕周为31.7周。94%为早产儿，95%为低出生体重儿（LBW），除1例之外，所有患儿在诊断前均接受过外周静脉置管并使用过广谱抗生素。58%的患儿接受过机械通气，15%的患儿接受过肠外营养。持续性/复发性肺炎、呼吸暂停、嗜睡、大量胃内容物抽吸及腹胀是常见的临床表现。热带念珠菌、白色念珠菌和季也蒙念珠菌是最常见的分离菌株。血液和尿液是分离出念珠菌的主要部位。氟康唑是最常用的抗真菌药物，对其耐药率为24%。50%的患儿因各种原因死亡。在所有死亡病例中，三分之二与念珠菌有关。念珠菌所致死亡24例（占17%）。
