›› 2014, Vol. 32 ›› Issue (9): 816-.doi: 10.3969 j.issn.1000-3606.2014.09.005

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Clinical analysis for fungal septicemia in 23 neonates

YU Shijuan, LI Luquan   

  1. Neonatal Diagnosis and Treatment Center, Children’s Hospital of Chongqing Medical University, Training Base of Clinical Resident Standard Training in Chongqing, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, China
  • Received:2014-09-15 Online:2014-09-15 Published:2014-09-15

Abstract: Objective To investigate the risk factors, pathogens spectrum and antimicrobial susceptibility of neonatal fungal septicemia. Methods Medical records of 23 neonates with fungal septicemia from May 2009 to August 2013 were analyzed retrospectively. Results A total of 36 strains of fungi including 20 strains of Candida parapsilosis (55.6%) and 11 strains of Candida albicans (30.6%) were isolated from 23 patients. Fungal pathogens were susceptible to amphotericin and fluorouracil, with susceptibility being 69.4%-77.8%. Prematurity, low birth weight, application of broad-spectrum antibiotics and invasive operation might be the risk factors of fungal septicemia. Fifteen cases (65.2%) had good outcomes (survival or partial restoration), while 8 cases (34.8%) had poor outcomes (withdrawing therapy or death). The duration of antifungal therapy in good prognosis group was longer than that in poor prognosis group (t=2.982, P<0.05). No significant difference in indicators of liver and kidney function was observed between before antifungal therapy and within 2 weeks after treatment. Meanwhile, no significant difference of WBC was found between before antifungal therapy and within 2 weeks after treatment. The platelet counts were increased within one week after initial antifungal therapy (P <0.05). Conclusions Candida is the main pathogen of neonatal fungal  septicemia and sensitive to amphotericin B. Long enough course of antifungal therapy is necessary to improve the cure rate.