新生儿真菌血流感染临床特点及危险因素分析

Clinical characteristics and risk factors of fungal blood infection in neonates

目的 分析新生儿真菌血流感染的病原菌、耐药情况及相关危险因素,为临床治疗提供参考。方法 对2016年1月-2017年12月本院新生儿病房收治的4 276例患儿进行回顾性研究,分析真菌血流感染临床特点。结果 4 276例新生儿住院患者中,血培养共检出真菌21例,主要为白色念珠菌9株（42. 9%）,其次为热带念珠菌5株（23. 8%）,药敏结果显示对常用抗真菌药物较敏感。单因素Logistic回归分析显示,早产儿、低出生体质量儿、气管插管、抗菌药物使用时间和中心静脉置管时间与真菌血流感染的发生有关（P 〈0. 05）;多因素Logistic回归分析表明,真菌血流感染的独立危险因素主要有早产儿和低出生体质量儿（P 〈0. 05）。结论 新生儿真菌血流感染病原菌以念珠菌为主,对常用抗真菌药物敏感性较高;早产儿和低出生体质量儿是新生儿真菌血流感染发生的高危人群。

Objective To analyze the pathogenic bacteria, drug resistance and risk factors of fungal blood infection in neonates, so as to provide guidance for clinical treatment. Methods A total of 4 276 hospitalized neonates in Neonate Ward from January 2016 to December 2017 were enrolled in the study, and clinical characteristics of the neonates with fungal blood infection were analyzed. Results Among the 4 276 hospitalized neonates, 21 cases had fungal blood infections, which was mainly Candida albicans （42.9%）, followed by Candida tropicalis （23.8 % ）. The result of drug susceptibility testing showed Fungi was suscep- tible to the commonly used antifungal drugs. Single factor Logistic .analysis showed that fungal blood infection was positively associated with premature, low - birth weight infant, endotracheal intubation, the using time of antibiotics and the time of cen- tral venous catheterization （ P 〈 0.05 ）. Multivariate Logistic regression analysis showed that the premature and low - birth weight infant were the independent risk factors for fungal blood infection in neonates （P 〈 0.05 ）. Conclusion Candida is the main pathogen of neonatal fungal blood infection and highly sensitive to the commonly used antifungal drugs. Premature and low - birth weight are the high risk factors for fungal blood infection in neonates.