早产儿念珠菌感染课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,早产儿念珠菌感染,提要,。简要背景,。流行病学资料和主要菌株,。发病危险因素,临床特征和预后,预防和治疗,简要背景,+靠震和春病产儿存套连多危险易感因素,真,比较易,+最常见临床念珠菌感染类型,念珠菌败血症,侵袭性念珠菌病,中枢神经系统念珠菌感染,+几乎所有脏器均可受累,血液神经系统,脑膜,脏器间质大脑,肾脏,眼,肯胎和关罗脏命受,累,+死亡率高且存活者留有包括神经发育损害的后,遗症,流行病学资料,+发病率/流行率,念珠菌败血症累积发病率:7%,出生体重1,500g新生儿侵袭性念珠菌病:ELBW念珠菌感染率:7%-20%,Curr Opin nfect Dis 2019 Dec:20(6):592,ELBW念珠菌感染率:9%,Pediatrics 2019 Oct:126(4 e865,年发病率:439/10000新生儿,Australia,2019-201997%病例诊断为住院新生儿,Pediatrics 2009 May:123(5):1360,总体发病率:15病例/10,000住院新生儿,(95%C|:13-16/10,000),Clin Infect Dis 2019 May 1:44(9):1187,流行病学资料,+2019意大利资料:6NCUs监测:,总发病率:13%,n=1597,VLBW 4%,n=248,ELBW4.7%,n=171,LBW 0.2%,I IF Inddence In 6 NICUs Induded in the surveillance,NICUs No of beds No admitted No(%)IFls Incidence/100 admitted,240,7033,4,2.9,ABcDEF,6o8848,220,4(190,18,280,3(14.3,331,3014.3,259,2(9.5,2(9.5,Total,1597,21t0o,1.3,J prev med hyg 2019:51:125-7s0,流行病学资料,+中国NCUs多中心调查资料20092019,发病率,center Beds Dischar,Case Case%,cases,Preterm,LBW,VLBW,1340,30224,908,0.77,11.56,B,4187,031,2814,0.25693,0.87,16,1672,4,0.24,225,0.89,1228,963,0.21,133,52,1812,6,0.33,14750.0014,17,3304,06,0.47,39501042.63,1.90,3677,2671,0.41,0.13,405,3386,190.56,0.19,337,4.15,2818,0.18,0.00,334,Total 444,300452230.74,213340.45,3643,3.32,HP Xia.X Zhou,J X Zhu,et al Mu/-center cinical survey of Candida infection in the NCUs in the three years during 2009 to 2019 in China:,Unpubished c,主要菌株,+australia,年龄1月,菌株,%,Candida albicans白色,Candida parapsilosis近平滑,42.4,Candida glabrata光滑,Candida tropicalIs,热带,Candida dubliniensis杜比,333,Polycandidal多重,Pediatrics 2009 May:123(5):1360,主要菌株,+中国NCUs多中心调查资料20092019,主要菌株,菌株(%),200920192019 overall,Candida albicans白色,86.4,56.751.6,Candida parapsilosis近平滑,2.3,143,3.0,8.5,Candida glabrata光滑,2.3,179193,Candida tropicalis热带,6.8,2.7,15,Candida guilliermondi季也蒙,0.0,4,10.4,5.8,Candida famata无名,0.0,4.5,7.5,4.5,Candida humicola土生隐球酵母,0.0,0.0,04,Candida kruse克柔,0.0,0.0,15,04,Candida lusitaniae葡萄牙,0.0,1.8,0.0,0.9,Others:Debaryomyces etchellsii,etc.2.3,0.0,1.5,0.9,multiple candida cases:5,HP Xia.XYZhou,J X Z,et al Mu-center cinical survey of Candida infection in the NCUs in the three years during 2009 to 2019 in China:,发生念珠菌感染的独立危险圆素,+ELBW队列研究:US NICHD,20199月至201912月,n=320(7%)/4,579,生后3d进展为念珠菌感染,念珠菌培养阳性:血液;307,CSF:27,+多元回归分析结果的独立危险因素,因素,OR.95%Cl,出生体重750g322,247-4.190001,头孢菌素应用,177,1.31-238.0002,无肠内喂养,肠内喂养,0.57,0420.79,p0006,男性,126,1.01-1.620443,Pediatrics 2019 Jan:117(1):84,发生念珠菌感染的相关危险因素,+前瞻性ELBW队列研究,n=137(9%/1,515,US,+与侵袭性念珠菌感染相关危险因素,因素,纠正oR(95%c),应用广谱抗生素198(1.37286),0003,中心静脉置管,1.94(1.17321),0098,静脉应用脂肪酸1.66(0.98281),.0596,气管插管,1.58(1.07235),0226,出生前皮质激素1.40(0.972.03),0747,Pediatrics 2019 Ocf:126(4),