Clinical analysis of 3 casesof very preterm/extremely preterm infant with bloodstream infection caused by multi-drug resistant Candida haemulonii

Abstract

Abstract: Objective To explore the clinical characteristics,treatment and prognosis of bloodstream infection caused by multi-drug resistant Candida haemulonii in premature infants. Methods The clinical data of premature infants with candidemia caused by multi-drug resistance Candida haemulonii in October 2017 were retrospectively analyzed, and the relevant literatures were reviewed. Results The gestational age of these three very preterm/extremely preterm infants was 25 weeks^{+ 1}, 30 weeks and 30 weeks, respectively. And the birth weight was 725 g, 1 000 g and 1 070 g, respectively. The time of infection was 45, 24, 28 days after hospitalization, respectively. All 3 cases had peripheral central venous catheterization(PICC). Broad-spectrum antibiotics were administered and low doses fluconazole was used to prevent fungal infection in all cases before candidemia occurred, The total of 4 strains of Candida haemulonii isolated from the blood cultures and 2 strains from the catheter were all resistant to fluconazole, amphotericin B, itraconazole, voriconazole and 5-fluorocytosine,but were sensitive to micafengin. Fluconazole and/or voriconazole did not improve the clinical condition of 3 patients, and finally they were treated with micafengin and recovered, without obvious side-effects about liver, kidney and blood. Conclusion It should be concerned vigilantly the occurrence of multi-drug resistant non-albicans candidemia in very preterm/extremely preterm infants with fluconazole for prevention of fungal infection. Micafungin is effective and tolerated in the treatment of multidrug-resistant Candida haemulonii bloodstream infection in premature infants.

Key words: infant, premature, Candida haemulonii, bloodstream infection, micafungin

CLC Number:

R519.3

ZHONG Meizhen, GUO Shaoqing, LI Xiaozhong, ZHU Bo. Clinical analysis of 3 casesof very preterm/extremely preterm infant with bloodstream infection caused by multi-drug resistant Candida haemulonii[J]. Chinese Journal of Mycology, 2023, 18(2): 111-116,134.

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