Clinical Analysis Of Premature Infants With Fungal Septicemia In Neonatal Intensive Care Unit

Objective To investigate the clinical features, the risk factors, pathogens spectrum, and antimicrobial susceptibility of fungal septicemia in premature infants, in order to provide evidence for clinic prevention, diagnosis and early treatment. Methods Retrospective analysis was performed to analyze the maternal conditions during pregnancy and clinical characteristics in premature infants who has admitted since January 2010 to December 2012 to the NICU of a tertiary hospital in China. The data were divided into observer group(30 cases) and control group( 125 cases) to statistical analysis. The general data including gender, gestational age, age, birth weight, mode of delivery, days of hospital stay, complication of mother, Apgar score, the complication during hospitalization. Except, we must record the clinical characteristics, laboratory findings, antimicrobial susceptibility, treatment and outcome in case group. The differences between groups by chi-square test, multivariate analysis using logistic regression analysis. Results 1.Candida albicans is the most common pathogens, accounting for 83.3%, followed by glabrata, accounting for 13.3%. 2.The onset time of the fungal septicemia was 6~42 d(15.70 ± 9.02 d). Seasonal incidence are more concentrated in the summer(47.7%). 3. The commonest clinical manifestations were poor general activity(83.3%), feeding difficulty(83.3%), decreased oxygen saturation(66.7%), frequent apnea(53.3%) and fever(53.3%). The clinical presentations of fungal septicemia in premature infants were non-specific. 4.The single factor analysis of the fungal septicemia in premature infants showed that gestational age, birth weight, pneumonia and PICC were related to the incidence of fungal septicemia. 5. Multivariate logistic regression analysis showed that pneumonia and PICC were the major risk factors for fungal septicemia. Conclusion Candida albicans is the main pathogen for the fungal septicemia in premature infants. Fungal septicemia should be considered for high-risk preterm infants at 2~3 weeks of age when there is poor activity, poor feeding, decreased oxygen saturation, apnea and fever. Gestational age, birth weight, pneumonia and PICC are important factors for fungal septicemia. Antifungal prophylaxis should be recommended for preterm infants who have risk factors in high-occurrence season to decrease the morbidity and mortality.