关键词: 败血症, 真菌, 新生儿

Abstract: Objective To analyze clinical feature of 30 neonates with fungal sepsis, in order to improve the level of diagnosis and treatment.Methods Totally 30 neonates with fungal sepsis and 78 premature infants with fungal sepsis were included in this study. Clinical manifestations, pathogens, laboratory findings and treatment outcomes were analyzed. The differences of laboratory parameters between fungal sepsis and bacterial sepsis were also analyzed.Results Of these cases, 25 cases(83.3%) were premature infants, and 28 cases(93.3%) had low birth weight. Risk factors included use of broad-spectrum antibiotics (29, 96.7%), tracheal intubation (18, 60.0%) and central vein catheterization (14, 46.7%). Clinical manifestations included fever, apnea and shortness of breath. Compared with premature bacterial sepsis cases, there were fewer cases with elevated procalcitonin (PCT) and more cases with thrombocytopenia in neonates with fungal sepsis (both P<0.01). G test showed that 8 out of 9 cases had positive results(88.9%). The pathogens were all Candida, including 19 strains of Candida albicans(63.3%) and 11 strains of non-Candida albicans(36.7%). For Candida albicans, all strains were susceptible to amphotericin, 14 strains were susceptible to fluconazole, while 3 strains were resistant to fluconazole and 2 strains were intermediate. All non-Candida albicans were susceptible to tested drugs. Totally 25 cases(83.3%) were cured after treatment.Conclusions The clinical manifestations of neonatal fungal sepsis were nonspecific. G test, PCT and platelet count were helpful for the diagnosis. Candida albicans were main pathogens in this study with some drug-resistant strains. Proper drug should be selected with the guidance of drug sensitive test.

Key words: sepsis, fungus, newborns