Clinical features of fungal septicemia in 18 premature infants / 中国感染控制杂志

ABSTRACT

Objective To analyze the clinical features of fungal septicemia in premature infants in a hospital,and provide reference for clinical diagnosis and treatment.Methods Clinical data of 18 premature infants with fungal septicemia in a hospital between January 2011 and December 2013 were analyzed retrospectively.Results Gesta-tional ages of 18 premature infants were 27-36 weeks,birth weights were 1 050 g-3 100 g,8 of whom were very low birth weight infants(VLBWI);all premature infants were treated with broad-spectrum antimicrobial agents,and were given long-term parenteral nutrition before infection,10 with mechanical ventilation,2 with peripherally insert-ed central catheters(PICC).The main clinical manifestations were apnoea,twitch,feeding difficulty,and poor reac-tion;manifestations appeared 3 hours-52 days after birth.13(72.22%)premature infants had abnormal white blood cell count,12 (66.67%)had thrombocytopenia (< 100 × 109/L),18 (100.00%)had elevated C-reactive protein (CRP),the average CRP level was (41 .90 ±26.77)mg/L.The main pathogens were Candida spp .(n = 17, 94.44%),including Candida parapsilosis (n=7),Candida albicans (n =5 ),biovariety of Candida albicans (n =4),and Candida famata (n=1);premature infants were treated with fluconazol and amphotericin B,15 (83.33%) were cured,2 (11 .11 %)improved,and 1 (5.56%)died.Conclusion Fungal septicemia in premature infants are mainly caused by Candida,there is no specific clinical manifestations,clinical symptoms in premature infants with high risk factors should be closely observed,blood routine and CRP should be detected periodically,timely treat-ment with antifungal agents should be given,which are beneficial to achieve good therapeutic effect.