[1]李　贝.早产儿真菌性败血症的病原菌分布及危险因素分析[J].新乡医学院学报,2018,35(8):705-707.[doi:10.7683/xxyxyxb.2018.08.014]
　LI Bei.Pathogenic bacteria distribution and risk factors of fungal septicemia in preterm infants[J].Journal of Xinxiang Medical University,2018,35(8):705-707.[doi:10.7683/xxyxyxb.2018.08.014]
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早产儿真菌性败血症的病原菌分布及危险因素分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年8
页码:
705-707
栏目:
临床研究
出版日期:
2018-08-05

文章信息/Info

Title:
Pathogenic bacteria distribution and risk factors of fungal septicemia in preterm infants
作者:
李　贝
（焦作市妇幼保健院新生儿科，河南　焦作　454000）
Author(s):
LI Bei
（Department of Neonatology，Jiaozuo Maternal and Child Health-Care Hospital，Jiaozuo 454000，Henan Province，China）
关键词:
早产儿; 真菌性败血症; 病原菌; 危险因素
Keywords:
premature infants; fungal septicemia; pathogenic bacteria; risk factor
分类号:
R515.3
DOI:
10.7683/xxyxyxb.2018.08.014
文献标志码:
A
摘要:
目的　探讨早产儿真菌性败血症的病原菌分布及危险因素。方法　选择2014年5月至2017年5月焦作市妇幼保健院收治的真菌性败血症早产儿35例为观察组，另选择非败血症早产儿55例为对照组；采集2组早产儿血样，进行真菌培养及鉴定；对2组早产儿的一般临床资料、实验室检查结果、病原菌分布情况进行比较，并采用Logistic多元回归分析早产儿真菌性败血症的危险因素。结果　35例真菌性败血症早产儿的病原菌主要有近平滑假丝酵母菌、白假丝酵母菌、罗伦特隐球菌、无名假丝酵母菌、葡萄牙假丝酵母菌、粉状毕赤酵母菌、季也蒙假丝酵母菌，其中近平滑假丝酵母菌、白假丝酵母菌、罗伦特隐球菌、无名假丝酵母菌分别占42.86%（15/35）、17.14%（6/35）、14.29%（5/35）、11.43%（4/35）。2组早产儿的性别、胎龄及体质量比较差异均无统计学意义（P>0.05）；2组早产儿肺炎、肺透明膜病、坏死性小肠结肠炎及硬肿症发生率比较差异均无统计学意义（P>0.05）；观察组早产儿住院时间长于对照组（P<0.05），观察组早产儿巨细胞病毒感染率、应激性溃疡发生率、发病前已达全胃肠道喂养率、经鼻持续气道正压通气率高于对照组（P<0.05）；观察组早产儿氟康唑预防性应用率低于对照组（P<0.05）。Logistic多元回归分析显示，发病前已达全胃肠道喂养、应激性溃疡及巨细胞病毒感染是早产儿真菌性败血症的危险因素（P<0.05）。结论　早产儿真菌性败血症的病原菌以假丝酵母菌多见，其中近平滑假丝酵母菌比例最高。发病前已达全胃肠道喂养、应激性溃疡及巨细胞病毒感染是早产儿真菌性败血症的危险因素。
Abstract:
Objective　To investigate the pathogenic bacteria distribution and risk factors of fungal septicemia in preterm infants.Methods　Thirty-five premature infants with fungal septicemia in Jiaozuo Maternal and Child Health-Care Hospital from May 2014 to May 2017 were selected as the observation group，and fifty-five premature infants without septicemia were selected as the control group.The blood samples of the premature infants in the two groups were collected for fungal culture and identification.The general clinical data，laboratory examination results and the distribution of pathogenic bacteria of preterm infants were compared between the two groups，and the risk factors of fungal septicemia in premature infants were analyzed by logistic multiple regression.Results　The pathogenic bacteria of 35 premature infants with fungal septicemia were mainly Candida parapsilosis，Candida albicans，Cryptococcus laurentii，Candida famata，Candida lusitaniae，Pichia farinose and Monilia guilliermondii，including Candida albicans，Candida albicans，Cryptococcus Lorent，and Candida albicans.Candida Nami accounted for 42.86% （15/35），17.14% （6/35），14.29% （5/35） and 11.43% （4/35） respectively.Among the pathogenic bacteria，there were 42.86% （15/35），17.14% （6/35），14.29% （5/35） and 11.43% （4/35） of Candida parapsilosis，Candida albicans，Cryptococcus laurentii and Candida famata respectively.There was no significant difference in sex，gestational age and body weight between the two groups （P>0.05）.There was no significant difference in the incidence of pneumonia，hyaline membrane disease，necrotizing enterocolitis and sclerosis between the two groups （P>0.05）.The hospitalization time of premature infants in the observation group was longer than that in the control group （P<0.05）.The incidence of cytomegalovirus infection，stress ulcer，full gastrointestinal feeding before the onset of disease and nasal continuous positive airway pressure of premature infants in the observation group were higher than those in the control group （P<0.05）.The prophylactic application rate of fluconazole in the observation group was lower than that in the control group （P<0.05）.Logistic multivariate regression analysis showed that full gastrointestinal feeding before the onset of disease，stress ulcers and cytomegalovirus infection were the risk factors for fungal septicemia in preterm infants （P<0.05）.Conclusion　Candida albicans is the most common cause of fungal septicemia in premature infants，and the proportion of Candida parapsilosis is the highest.The full gastrointestinal feeding before the onset of disease，stress ulcers and cytomegalovirus infection are the risk factors for fungal septicemia in preterm infants.

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更新日期/Last Update: 2018-08-05