机械通气新生儿深部真菌感染18例

目的探讨机械通气新生儿深部真菌感染的临床和病理特点。方法分析1985~2003年我科经尸检证实深部真菌感染的曾行机械通气的18例新生儿的临床和病理资料。结果18例新生儿中,曲霉菌感染8例,白色念珠菌感染6例,毛霉菌4例。肺部真菌感染12例,肝脏真菌感染4例,脑部、胃肠道真菌感染各2例。其中2例同时存在肺部和肝脏真菌感染。结论机械通气新生儿深部真菌感染不容忽视,曲霉菌和白色念珠菌为主要病原菌。主要受累器官为肺。早期诊断是提高存活率的有效途径。

Clinical Analysis of 18 Neonates with Deep Fungus Infection under Mechanical Ventilation

Objective To explore the clinical and pathologic characteristic of deep fungus infection under mechanical ventilation in neonate. Method The clinical datas of 18 neonates under mechanical ventilation approved with deep fungus infection by autopsy from 1985 to 2003 in our department were collected and analyzed.Results In 18 infants who survived deep fungus infection,2 cases were premature and 16 cases were mature,the birth weight and the numbers of patients were:<1000 g 6 cases;1000-1499 g 8 cases;(1500-2500 g) 2 cases;>2500 g 2 cases;Time under mechanical ventilation was 8-86 days and the average time under mechanical ventilation was 13 days. The pathogen caused deep fungus infection was Aspergillus(8/18),Candida albicans(6/18) and Mucor(4/18),respectively. The infected organ were lung(12/18),brain(2/18),liver(4/18) and gastrointestinal tract(2/18),respectively.Two of them were found been infected in lung and liver at the same time.Conclusions We must attach importance to deep fungus infection in neonate under machine ventilation.Aspergillus and Candida albicans were the main pathogen bacteria and lung was the main infected organ of neonatal deep fungus infection.Early diagnosis may be the efficiency approach to increase livability.