Risk Factors Of Invasive Fungal Infection In Premature Infants

Objective:To explore the risk factors of invasive fungal infection in premature infants,and to provide a theoretical basis for clinical rational prevention of fungal infections.Methods:This study used retrospective analysis to collect clinically relevant data of premature infants admitted to the Department of Neonatal Medicine,Children's Hospital Affiliated to Kunming Medical University from April 2014 to April 2018 The included medical records were divided into two groups according to the standards,including Premature infants with invasive fungal infection were included in the infection group,and premature infants without invasive fungal infection were included in the control group.Analyze and compare the gender,gestational age,birth weight,age,length of hospital stay,duration of antibiotic use,tracheal intubation rate and time,PICC placement rate and time,TPN time,whether to use antifungal drugs,breastfeeding before hospitalization,conditions of prognosis and other data,those data were statistically analyzed using SPSS 25.0 statistical software to analyze single risk factors,multiple factors,and independent risk factors for invasive fungal infection in preterm infants.Results:1.In the neonatal department of our hospital,3,972 preterm infants were treated from April 2014 to April 2018,of which 31 cases had IFI,and the infection rate was 0.76%.According to the inclusion criteria,317 premature infants were included.After standard exclusion,there were a total of 274 cases,including 30 cases in the infection group and 244 cases in the control group;2.9 cases of fungi were detected in blood cultures,and the positive rate was 30%,all of which belonged to Candida.Six of them underwent a drug sensitivity test,and the results indicated that the six strains of Candida albicans were all sensitive to amphotericin,one was resistant to caspofungin,and four were resistant to fluconazole;3.General conditions of the two groups There was no statistically significant difference between the two groups in comparing gender and age(P<0.05),while the differences in birth weight and gestational age between the two groups were statistically significant(P<0.05);4.Among the preterm infants in the infection group,There were 28 cases of(1,3)-?-D glucan test(>100pg/mL),the positive rate was 93.3%.5.Gestational age,birth weight,antibiotic use time,TPN time,PICC catheterization and indwelling time,tracheal intubation and intubation time,preventive use of antifungal drugs,length of hospital stay,breastfeeding before hospitalization for premature infants Risk factors for IFI infection(P<0.05).PICC intubation days and tracheal intubation days were independent risk factors for IFI in preterm infants.6.There was no significant difference in prognosis between the two groups(P>0.05).Conclusion(s):1.The infection rate of invasive fungal infection in premature infants in this study was 0.76%.2.In this study,the positive rate of blood culture was 30%,and the fungal species were Candida genus,mainly Candida albicans;(1,3)-?-D glucan detected a positive rate of 93.3%.3.This study concluded that the risk factors for IFI in preterm infants are gestational age,birth weight,antibiotic use time,TPN time,PICC placement and indwelling time,tracheal intubation and intubation time,prevention of antifungal drugs,The length of hospital stay and breastfeeding before hospitalization were risk factors for IFI infection in preterm infants(P<0.05).4.Logistic regression analysis showed that PICC intubation days and tracheal intubation days were independent risk factors for IFI in preterm infants.