新生儿真菌败血症10例临床分析

The clinical analysis of neonatal fungi sepsis 10 cases

目的分析新生儿真菌败血症的相关因素,进一步探讨其早期诊断、防治方法。方法对2007年3月1日—2012年3月1日期间住我院新生儿科确诊的新生儿真菌败血症10例进行回顾性分析。结果 10例中白色假丝酵母菌5例,光滑假丝酵母菌2例,其他假丝酵母菌2例,克柔假丝酵母菌1例。使用有创呼吸机3例,无创呼吸机4例,中心静脉置管8例,持续使用广谱抗菌药物8例,进入新生儿重症监护室(NICU)治疗10例(100%),粒细胞减少4例,可能为相关因素;死亡1例。结论新生儿真菌败血症以白色假丝酵母菌属为主,非白色假丝酵母菌属感染比例增多,早产儿是NICU中真菌感染高危儿,深部真菌感染病例中中心静脉置管率较高,与呼吸机应用相关。对于有高危因素疑诊深部真菌感染者应早期开始经验性治疗、预防。

Objective To analyze some possible factors of fungus sepsis,and further discuss its early diagnosis, prevention and cure. Method 10 cases of newborn neonatal sepsis which try to be cured in our hospital during 2007.03.01~2012.03.01 were clinically analyzed in a retrospective sense. Results In the total 10 cases,5 cases indicates Candida albicans, 2 case shows smooth candida,2 cases with other candida,and 1 case represents Candida krusei. In the respective of therapy,various methods have been carried out,including sub-invasive ventilator breathing machine（3 cases）,Noninvasive ventilator （4 cases）,Peripherally Inserted Central Catheter （PICC）（8 cases）,continuous taking antibacterial drugs（8 cases）, enter NICU therapy（100%） and granulocytopenia（4 cases）,and died（1case）.Conclusion The Candida albicans are the main part, The infection rates of others increase .premature infants NICU is in highly risk in fungal infection, The rate of PICC is higher in deep fungus infections, which also related to ventilator application. Risk factors for suspected fungal infection of the deep diagnosis should be empirically treated and prevented early.