CAJ | 학술논문

目的了解新生儿血液近平滑假丝酵母菌感染的临床特点和药敏结果,为临床预防和诊治提供参考.方法对8例新生儿血培养中分离出的近平滑假丝酵母菌进行药敏分析,并回顾性分析感染患儿的临床特点.血培养采用BD9120血培养仪,沙保罗培养基分离培养,科玛嘉(CHROMagar)酵母菌显色培养基及API20C真菌鉴定板,药敏试验采用FUNGUS3微量稀释版.结果近平滑假丝酵母菌抗真菌药敏结果分别为5-氟胞嘧啶≤4 μg/ml,两性霉素B≤0.5 μg/mL,氟康唑≤1～2.0μg/ml,伊曲康唑≤0.125～0.125 μg/ml,伏立康唑≤0.06～0.06 μg/ml.7例为早产儿(低出生体重或超低出生体重儿),1例足月先天幽门闭锁术后患儿.8例患儿血培养前均应用广谱抗生素和静脉营养治疗,均曾留置中心静脉导管,3例曾应用机械通气.4例用氟康唑,3例氟康唑联合两性霉素B脂质体,1例先用氟康唑后用威凡,8例患儿全部治愈.结论近平滑假丝酵母菌已成为早产、低出生体重儿血液真菌感染的主要病原菌之一,对5种常用抗真菌药物体外药敏试验均敏感,及早发现和治疗愈后较好.
목적 료해신생인혈액근평활가사효모균감염적림상특점화약민결과,위림상예방화진치제공삼고.방법 대8례신생인혈배양중분리출적근평활가사효모균진행약민분석,병회고성분석감염환인적림상특점.혈배양채용BD9120혈배양의,사보라배양기분리배양,과마가(CHROMagar)효모균현색배양기급API20C진균감정판,약민시험채용FUNGUS3미량희석판.결과 근평활가사효모균항진균약민결과분별위5-불포밀정≤4 μg/ml,량성매소B≤0.5 μg/mL,불강서≤1～2.0μg/ml,이곡강서≤0.125～0.125 μg/ml,복립강서≤0.06～0.06 μg/ml.7례위조산인(저출생체중혹초저출생체중인),1례족월선천유문폐쇄술후환인.8례환인혈배양전균응용엄보항생소화정맥영양치료,균증류치중심정맥도관,3례증응용궤계통기.4례용불강서,3례불강서연합량성매소B지질체,1례선용불강서후용위범,8례환인전부치유.결론 근평활가사효모균이성위조산、저출생체중인혈액진균감염적주요병원균지일,대5충상용항진균약물체외약민시험균민감,급조발현화치료유후교호.
Objective To study the clinical characteristic and antifungal drug sensitivity of neonatal Candida parapsilosis infections in blood and to provide reference for clinical prevention and therapy.Methods The drug resistance of Candida parapsilosis which were isolated from 8 neonatal blood specimen on the laboratory were analyzed and clinical characteristic of infections in neonates were investigated retrospectively.The blood cultured with BD9120.The fungi were isolated with Sabourand Dextrose Agar and CHROMagar colored medium and identified with API20C.The susceptibility test was then performed with FUNGUS3 micro dilution plate.Results Candida parapsilosis susceptibility results to antifungal drugs showed that 5-flucytosine≤ 4 μg/ml,amphotericin B ≤ 0.5 μg/ml,fluconazole ≤ 1 ～ 2.0 μg/ml,itraconazole ≤ 0.125 ～0.125 μg/ml,voriconazole ≤0.06 ～0.06 μg/ml.Seven cases were preterm infants(low birth weight infants or extremely low birth weight infants),one case was term infant after operation of congenital pyloric atresia.Before blood culture,all the 8 cases of Candida parapsilosis sepsis had received broad-spectrum antibiotics and intravenous nutrition.All the 8 cases had received peripherally inserted central catheter,and 3 cases had received mechanical ventilation.Four cases with fluconazole,3 cases with fluconazole and amphotericin B,1 case with fluconazole at the onset but changed VFend,all 8 cases were cured.Conclusion Candida parapsilosis has become the one of the main pathogens of neonatal infection fungal in blood of premature or low birth weight infants,which is sensitive to 5 kinds of antifungal drugs in vitro susceptibility test.Early detection and antifungal therapy can improve the prognosis.