Clinical analysis for fungal septicemia in 23 neonates / 临床儿科杂志

ABSTRACT

Objective To investigate the risk factors, pathogens spectrum and antimicrobial susceptibility of neonatal fungal septicemia. Methods Medical records of 23 neonates with fungal septicemia from May 2009 to August 2013 were analyzed retrospectively. Results A total of 36 strains of fungi including 20 strains of Candidaparapsilosis (55.6%) and 11 strains of Candidaalbicans (30.6%) were isolated from 23 patients. Fungal pathogens were susceptible to amphotericin and lfuorouracil, with susceptibility being 69.4%-77.8%. Prematurity, low birth weight, application of broad-spectrum antibiotics and invasive operation might be the risk factors of fungal septicemia. Fifteen cases (65.2%) had good outcomes (survival or partial restoration), while 8 cases (34.8%) had poor outcomes (withdrawing therapy or death). The duration of antifungal therapy in good prognosis group was longer than that in poor prognosis group (t=2.982, P<0.05). No significant difference in indicators of liver and kidney function was observed between before antifungal therapy and within 2 weeks after treatment. Meanwhile, no signiifcant difference of WBC was found between before antifungal therapy and within 2 weeks after treatment. The platelet counts were increased within one week after initial antifungal therapy (P<0.05). Conclusions Candida is the main pathogen of neonatal fungal septicemia and sensitive to amphotericin B. Long enough course of antifungal therapy is necessary to improve the cure rate.