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目的探讨住院儿童无菌体液部位深部真菌感染的发生特点、病原学种类及治疗转归情况。方法回顾性分析2007年4月-2009年12月16例诊断为深部真菌感染的住院儿童临床资料,探讨真菌感染的易感因素、病原学特点及治疗效果。结果易感因素有:侵入性操作(16/16),使用广谱抗生素≥4d(15/16),手术(8/16),应用呼吸机(8/16);致病菌为白色念珠菌11例,热带念珠菌3例,新型隐球菌1例,毛霉菌1例。15例经抗真菌治疗者2例死亡,1例患儿在未证实真菌感染前死亡。结论住院儿童无菌体液部位深部真菌感染与多种易感因素有关,早期诊断及合理选用抗真菌药物是治愈的关键。
Objective To investigate the characteristics of deep fungal infection in sterile fluid in hospitalized children, the types of etiology and the outcome of treatment. Methods The clinical data of 16 hospitalized children diagnosed with deep fungal infection from April 2007 to December 2009 were analyzed retrospectively to investigate the susceptible factors, etiological characteristics and therapeutic effects of fungal infection. Results The predisposing factors included invasive procedure (16/16), broad-spectrum antibiotics ≥4 days (15/16), surgery (8/16) and ventilator (8/16). The pathogen was Candida albicans 11 cases, 3 cases of tropical Candida, 1 case of new cryptococcosis, 1 case of mold. Two of 15 patients died of antifungal therapy and 1 patient died before an unidentified fungal infection. Conclusion The deep fungal infection of sterile fluid in hospitalized children is related to a number of susceptible factors. Early diagnosis and rational use of antifungal drugs are the key to cure.