Analysis Of Risk Factors And Pathogen For Invasive Fungal Infection In Neonates

Objective : To explore the risk factors and pathogen for invasive fungal infection(IFI)in neonates.Methods:A Retrospective case-control studies were used,A total of56 neonates diagnosed with IFI from January 2013 to December 2017 in the neonatal intensive care unit of Children’s Hospital affiliated to Chongqing Medical University were included in the case group.According to gestational age,discharge time,etc.168 children with non-IFI were included in the control group,Collecting case data and analyzing the risk factors and pathogen of neonatal IFI.Results:Analysis showed that the risk factors for neonatal IFI are as follows:hypoglobulin,needing of intravenous gamma globulin,low albumin,low red blood cells,low platelets,needing of infusion of plasma,combined with sepsis,using multiple antibiotics,long-term intravenous nutrition,peripherally inserted central catheter(PICC),total time of indwelling PICC,Bronchopulmonary dysplasia(BPD),neonatal necrotizing enterocolitis(NEC)(P < 0.05).Further binary logistic regression analysis found that,needing of intravenous gamma globulin((OR:4.189,95%CI: 1.527~11.489,P=0.044)),combined with sepsis(OR: 3.719,95%CI: 1.035 ~ 13.367,P=0.005),using multiple antibiotics(OR: 2.779,95%CI: 1.537 ~ 5.025,P=0.001),long-term intravenous nutrition(OR:1.039,95%CI: 1.003~ 1.075,P=0.034),are independent risk factors for neonatal IFI.The most pathogenic bacteria were Candida albicans(51.61%),followed by Candida parapsilosis(22.58%).Conclusion:Clinically suspected neonatal IFI and when the pathogen examination is difficult,if the newborn has intravenous gamma globulin,combined with sepsis,using multiple antibiotics,long-term intravenous nutrition and other high-risk factors,early empirical antifungal therapy should be based on the distribution of pathogen.