新生儿混合性念珠菌/细菌血流感染相关因素分析

中国真菌学杂志　 2021, Vol. 16 　Issue (6): 392-396.

论著上一篇

新生儿混合性念珠菌/细菌血流感染相关因素分析

谢朝云¹, 李文华², 杨忠玲³

1. 贵州医科大学第三附属医院急诊科, 都匀 558000;
2. 贵州医科大学第三附属医院新生儿科, 都匀 558000;
3. 贵州医科大学第三附属医院检验科, 都匀 558000

收稿日期:2020-08-26 发布日期:2021-12-29
作者简介:谢朝云,男(水族),硕士,主任医师.E-mail:xcu2009@163.com
基金资助:
贵州省科技厅联合项目；贵州省黔南州社会发展科技项目

Analysis of related factors of mixed Candida/bacterial bloodstream infections in neonates

XIE Zhaoyun¹, LI Wenhua², YANG Zhongling³

1. Department of emergency, the Third Affiliated Hospital of Guizhou Medical University, Duyun 558000, China;
2. Department of Neonatology, the Third Affiliated Hospital of Guizhou Medical University, Duyun 558000, China;
3. Department of laboratory, the Third Affiliated Hospital of Guizhou Medical University, Duyun 558000, China

Received:2020-08-26 Published:2021-12-29

摘要/Abstract

摘要： 目的探讨分析念珠菌血流感染患儿混合性念珠菌感染相关因素。方法回顾2013年3月—2020年6月225例念珠菌血流感染患儿临床资料,对其混合性念珠菌血流感染相关因素进行相关因素单因素与多因素分析。结果新生儿混合性念珠菌血流感染发生率为29.33%;单因素分析显示,出生胎龄(<37周)、出生体重(<2 500 g)、发病日龄(<7 d)、羊水污染、宫内窘迫、Apagar评分(<7分)、感染类型(医院感染)、入住NICU时间(≥7 d)、胎膜早破、住院时间(≥14 d)、侵入性治疗、APACHEⅡ评分(≥15分)、更换抗菌药物种数(≥3种)、血清白蛋白(<30 g/L)等14个因素是新生儿混合性念珠菌血流感染的相关因素(P< 0.05);多因素分析显示,出生胎龄(<37周)、感染类型(医院感染)、入住NICU时间(≥7 d)、住院时间(≥14 d)、侵入性治疗、APACHEⅡ评分(≥15分)、更换抗菌药物种数(≥3种)是新生儿混合性念珠菌血流感染独立危险因素(P<0.05)。结论减少住院时间、入住NICU时间、频繁更换抗菌药物与侵入性诊疗,加强医院感染防控,减少医院感染发生,合理使用抗菌药物,减少盲目多次更换抗菌药物,关注低体重与危重患儿救治,是减少新生混合性念珠菌血流感染的主要措施。

关键词: 新生儿, 混合性念珠菌, 血流感染, 因素分析

Abstract: Objective To investigate the related factors of mixed Candida/bacterial bloodstream infections in children. Methods The clinical data of 225 children with Candida bloodstream infection from March 2013 to June 2020 were reviewed. The related factors of mixed Candida/bacterial bloodstream infection were analyzed by univariate and multivariate analysis. Results The incidence of mixed Candida/bacterial bloodstream infection was 29.33%. Univariate analysis showed that gestational age (<37 weeks), birth weight (<2 500 g), age of onset (<7 D), amniotic fluid pollution, intrauterine distress, apagar score (<7 points), type of infection (hospital infection), length of stay in NICU (≥7 days), premature rupture of membranes, hospitalization time (≥14 days), invasive treatment, AP 14 factors such as ache Ⅱ score (≥15 points), the number of antibiotics replaced (≥3 kinds), serum albumin (<30 g/L) were the related factors of neonatal mixed Candida/bacterial bloodstream infection (P<0.05) Multivariate analysis showed that gestational age (<37 weeks), type of infection (nosocomial infection), length of stay in NICU (≥7 days), length of hospital stay (≥14 days), invasive treatment, Apache Ⅱ score (≥15 points) and the number of antibiotics changed (≥3 kinds) were independent risk factors of neonatal mixed Candida/bacterial bloodstream infection (P< 0.05). Conclusion The main measures to reduce the new mixed bloodstream infection are to reduce the hospitalization time, stay in NICU, frequently change antibiotics and invasive diagnosis and treatment, strengthen the prevention and control of nosocomial infection and reduce the occurrence of nosocomial infection, rationally use antibiotics and reduce blind multiple replacement of antibiotics, and pay attention to the treatment of low weight and critical children.

Key words: neonatal, mixed Candida/bacterial, bloodstream infection, factor analysis

中图分类号:

R519.3

谢朝云, 李文华, 杨忠玲. 新生儿混合性念珠菌/细菌血流感染相关因素分析[J]. 中国真菌学杂志, 2021, 16(6): 392-396.

XIE Zhaoyun, LI Wenhua, YANG Zhongling. Analysis of related factors of mixed Candida/bacterial bloodstream infections in neonates[J]. Chinese Journal of Mycology, 2021, 16(6): 392-396.

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新生儿混合性念珠菌/细菌血流感染相关因素分析

Analysis of related factors of mixed Candida/bacterial bloodstream infections in neonates

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