Analysis of clinical features on neonatal invasive fungal infection
ZHENG Tian, LI Qiu-ping, CHEN Hai-hua, et al
1.Neonatal Intensive Care Unit, BaYi Children's Hospital, The Seventh Medical Center, General Hospital of PLA, Beijing 100700, China; 2. Department of Information, The Seventh Medical Center, General Hospital of PLA, Beijing 100700, China
Abstract: 【Abstract】 Objective To analyze the clinical features of invasive fungal infections (IFI) in NICU, and to provide reference for prevention and treatment of IFI. Methods From January 2009 to December 2014, 102 cases with IFI in NICU, BaYi Children's Hospital, The Seventh Medical Center, General Hospital of PLA were investigated, whose clinical data were retrospectively analyzed, and the clinical features, clinical manifestations, laboratory examination, treatment and outcomes of the children were summarized. Results Total of 68 cases with IFI were male, 34 cases were female; 75 cases(73.5%) were preterm infants，with average gestational age (32.7± 4.4 ) weeks and average birth weight (1 898±913) g. The onset date of that was 1 to 99 days after birth, including 9 cases of early-onset (8.8%), 93 cases of late-onset (91.2%). 98 cases were positive blood cultures, 4 cases were positive cerebrospinal fluid cultures with negative blood cultures.Among of 103 isolated fungi, the top three of that were Candida albicans in 53 cases (51.5%), Candida parapsilosis in 26 cases (25.2%) and Candida glabrata in 9 cases (8.7%). Thirty-two cases (31.4%) had septic shock symptoms with gray skin and poor perfusion. The neutrophil number of 25 cases（24.5%）in peripheral blood was﹤1.0×109/L and the thrombocytopenia number of 68 cases（66.7%）in peripheral blood was﹤100×109/L respectively. The average value of fungal dextran was (853±623) ng/L through detecting. A total of 16 cases (15.7%) were found with end organ involvement, including 11 cases of fungal meningitis, 3 cases of fungal endophthalmitis, 2 cases with urinary tract infection. Eighty-four cases were cured (82.4%), 10 cases (9.8%) improved but discharged early because of worring about their outcome or economic reasons, 8 cases died (7.8%) by the treatment of fluconazole or voriconazole. Conclusion Premature infants and low birth weight infants are the main group of IFI, mainly composed of Candida albicans, with various clinical manifestations and with end organ involvement easily, high rate of poor prognosis, which is necessary to pay attention.
2019, Vol. 7 
