Dissertation > Medicine, health > Pediatrics > Newborns, premature children disease > Preterm children disease

Epidemiological Features and Pathogens of Fungal Sepsis in Premature Infants

Author ZhongZuoZuo
Tutor ChenHanQiang
School Fujian Medical
Course Pediatrics
Keywords premature infant fungal sepsis risk factor pathogens
CLC R722.6
Type Master's thesis
Year 2013
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Objective:Through analysis of incidence,demographic features,pathogens,risk factors,treatment and prognosis,further clarifying theoccurrence regularity, and regonizing those infants who are in of fungalsepsis high-risk to provide clinical guildance for early prevention andtreatment among those infants who are in high-risk of getting fungalsepsis.Methods:The clinical data of10435hospitalized premature infants in NICUin the FuJian Women And Children Hospital from January2001to December2012were analyzed retrospectively.27cases of premature infants who werediagnosed with fungal sepsis,54non-fungal sepsis premature infants whohad the closest admissive time and day-old were selected as controlgroup.Two groups were analyzed by case-control study in Logisticregression model.Exposure factors,clinical manifestations andlaboratory of Candida albicans and Candida parapsilosis were analyzed viaindependent samples T-test and non-parametric tests.Results:27cases were diagnosed with fungal sepsis,the incidence was0.26%,gestational age31.9+2.9weeks,birth weight1539+347g,length ofhospital stay40.1+17.3days.Pneumonia and hyaline membrane disease werethe most common basic comorbidity.The onset date was14.3+6.2days afterbirth.Delayed response(88.9%),abdominal distension (59.3%),apnea (51.9%)and thrombocytopenia (74.1%) were the most common presentingsymptoms.Althought the most common Candida strains was thought as Candidaalbicans,Candida parapsilosis attributed to the most of the cases from2007to2012.Single factor analysis showed that fungal sepsis in prematureinfants was significantly associated with gestational age,birthweight,stress ulcer,cytomegalovirus infection,nasal continuous positive airway pressure,fluconazole prophylaxis,time of feeding initiation andreached before the onset of full enteral feeding.The logistic regressionanalysis showed that stress ulcer was the main risk factor for fungalsepsis in premature infants,while reached before the onset of full enteralfeeding was protective factor.The analysis of Candida albicans andCandida parapsilosis showed that parenteral nutrition,fluconazoleprophylaxis,hyperglycemia and thrombocytopenia were statisticallydifferent.Conclusions: Fungal sepsis incidence of premature infants showed anincreasing trend and pathogens constitute have changed.Candidaparapsilosis was main pathogens.Thrombocytopenia and hyperglycemia ismore meaningful in Candida parapsilosis.Through strengthen themanagement of the gastrointestinal tract would significnatly reduceincidence of fungal sepsis in premature infants.

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