危重症儿童侵袭性真菌感染分析

Analysis of serious children patients by invasive fungal infections

目的探讨危重儿童侵入性真菌感染的发生特点,病原学种类及治疗。方法回顾性分析1996年1月￣2005年2月间的27例危重儿童真菌感染的易感因素、病原学特点及治疗效果。结果患儿病情危重,易感因素有:使用广谱抗生素(24/27),机械通气(16/27),深静脉置管(14/27),肠外营养(16/27),应用化疗药物(5/27),应用皮质醇激素治疗(6/27)。致病菌为白色念珠菌21例,热带念珠菌3例,酵母菌3例,曲霉菌1例。25例经抗真菌治疗者4例死亡,2例未治疗者死亡。结论危重儿童侵入性真菌感染与多种易感因素有关。合理选用抗真菌药物是治愈的关键。

[Objective] To study the clinical characteristics, fungal species, therapy of invaslve fungal infections. [Methods] A retrospective analysis of predisposing factors, distribution of fungi, treatment and outcome of 27 patients with invasive fungal infections from Jan 1996 to Feb 2005 was done. [Result] Each patient was serious, The most frequent predisposing factors were the use of broad-spectrum antibiotics（24/27）, mechanical ventilation（16/27） , indwelling central intravenous catheter（14/27）, parenteral nutrition （16/27）, chemotherapy （5/27）. Candida albicans species were the most frequently isolated. Four patients died among 25 patients being treated with antifungal drugs, while 2 patients died without antifungal therapy, [Conclusions] Invasive fungal infections usually occurred in serious patients with predisposing factors, choice of antifungal drugs are critical for the management of serious patients with invasive fungal infections.