某院近10年儿童侵袭性真菌感染状况分析

发布时间：2018-03-04 19:46

本文选题：儿童　切入点：侵袭性真菌感染　出处：《中华医院感染学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨某院近10年儿童侵袭性真菌感染状况,为医院提升治疗儿童侵袭性真菌感染患儿疗效提供科学依据。方法选取2006年7月-2016年7月医院儿科收治的侵袭性真菌感染患儿106例,统计每2年儿童侵袭性真菌感染的数量分布、感染病原菌的危险因素、分布和来源及临床症状、主要真菌病原菌的耐药性。结果 106例侵袭性真菌感染儿童共分离出真菌109株,儿童侵袭性真菌感染的总例数呈逐年上升趋势,其中,每年感染最多的菌落均为白念珠菌;影响儿童侵袭性真菌感染的危险因素包括广谱抗菌药物、激素的使用、中心静脉插管、血液系统肿瘤、胃肠手术以及留置导尿管;儿童侵袭性真菌感染中以念珠菌为主,包括白念珠菌33株(30.3%)、光滑念珠菌13株(11.9%),热带念珠菌12株(11.0%)以及克柔念珠菌9株(8.3%),其次为新隐球菌18株(16.5%),链格孢子菌7株(6.4%)以及曲霉菌11株(10.1%);儿童侵袭性真菌感染的来源主要为泌尿道和呼吸道,新隐球菌的主要来源为脑脊液;白念珠菌对伊曲康唑和氟康唑耐药性较强,对5-氟胞嘧啶较敏感,新隐球菌对伊曲康唑和氟康唑耐药性较强,对5-氟胞嘧啶和两性霉素B较敏感;儿童侵袭性真菌感染临床症状中以咳嗽、体温不稳定、喘息最为常见,偶尔有患儿伴随腹痛、腹胀和咳血的症状。结论儿童侵袭性真菌感染无临床特异性,对于其感染的相关危险因素且抗菌药物治疗无效的患者,需要更加深入地寻找真菌感染证据,对于确定真菌感染的患者应给予5-氟胞嘧啶和两性霉素B治疗,以期降低儿童侵袭性真菌感染率,提高治疗效果。
[Abstract]:Objective to investigate the status of invasive fungal infection in children in a hospital in recent 10 years. Methods 106 cases of invasive fungal infection were selected from July 2006 to July 2016. The number of invasive fungal infections, the risk factors, the distribution and origin of pathogenic fungi, the clinical symptoms and the resistance of major fungal pathogens were analyzed every 2 years. Results 109 strains of fungi were isolated from 106 children with invasive fungal infection. The total number of invasive fungal infections in children increased year by year, among which the most infected colonies were Candida albicans, and the risk factors affecting invasive fungal infections in children included broad-spectrum antimicrobial agents and the use of hormones. Central venous catheterization, hematological neoplasms, gastrointestinal surgery and indwelling catheters; Candida is predominant in invasive fungal infections in children. Including 33 strains of Candida albicans, 13 strains of Candida smooth, 12 strains of Candida tropicalis, 11.0) and 9 strains of Candida krolimus, followed by 18 strains of Cryptococcus neoformans, 18 strains of Cryptococcus neoformans, 7 strains of Streptomyzia 6.4) and 11 strains of Aspergillus, 11 strains of Aspergillus; 11 strains of Aspergillus; and 11 strains of invasive fungal infection in children. The main sources are urinary tract and respiratory tract. Candida albicans showed stronger resistance to itraconazole and fluconazole, sensitive to 5-fluorocytosine, and more resistant to itraconazole and fluconazole, while Candida albicans had stronger resistance to itraconazole and fluconazole, while Candida albicans had stronger resistance to itraconazole and fluconazole. The clinical symptoms of invasive fungal infections in children are cough, unstable body temperature, wheezing, and occasional abdominal pain. Symptoms of abdominal distention and hemoptysis. Conclusion invasive fungal infection in children has no clinical specificity. Patients with fungal infection should be treated with 5-fluorocytosine and amphotericin B in order to reduce the invasive fungal infection rate in children and improve the therapeutic effect.
【作者单位】：南阳医专第一附属医院儿三科;南阳医专第一附属医院儿一科;
【分类号】：R725.1

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