Characteristics,Risk Factors And Antifungal Susceptibilities Of Invasive Fungal Infection In Pediatrics Intensive Care Unit

Objective:To investigate Characteristics,risk factors and antifungal susceptibilities of Invasive fungal infection in department of pediatrics a tertiary care hospital in Urumqi.Improve clinicians' awareness and diagnostic level of invasive fungal infections,Provide reasonable drug use basis,Thereby improving the prognosis of invasive fungal infections.Methods:Collected the medical records of all children who were admitted to our hospital PICU from January 01,2015 to January 01,2019.Find 52 children who were diagnosis of invasive fungal infection.Analysis of its clinical features,risk factors,and drug resistance.Results: 41 fungi were isolated from 52 children diagnosed with fungal infection,of which 39(95.1%)were Candida,including23(58.9%)of Candida albicans,8(20.5%)of Candida parapsilosis,and tropical Candida was 3 cases(7.6%),Candida glabrata 3 cases(7.6%),Candida krusei 2 cases(3.9%),and Aspergillus spp.infection2cases(4.9%).The resistance rates of Candida to each drug were as follows: fluconazole:8%,voriconazole: 7%,itraconazole: 34%,caspofungin: 3%,micafungin,amphotericin B,No drug-resistant strains were observed in 5-fluorocytosine.Risk factors analysis showed that long-term use of antibiotics in hospitalized children with PICU was the most common risk factor(n=41,78.8%),followed by glucocorticoids(n=33,63.5%),and received tracheal insertion.Children with tube and mechanical ventilation(n=27,51.9%)had a higher incidence of invasive fungal infections.The percentage of children with malignant tumors and chemotherapy in the total cases was 46.2.6%,40.4%,and the proportion of invasive fungal infections in children with blood purification was small(n=1,1.9%).Conclusion:At present,the incidence of PICU invasive fungal infection is still high,and Candida albicans and non-Candida albicans infections are in the same proportion,andinvasive Aspergillus infections are rare.Prolonged use of antibiotics is the most common risk factor,and should be noted that antibiotics should be used rationally.Candida has a high resistance rate to fluconazole and itraconazole.No fungal strains resistant to benignin B,micafungin or 5-fluorocytosine have been found.Clinical use can be given priority.