ĐẶC ĐIỂM LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ NHIỄM NẤM CANDIDA XÂM LẤN TẠI KHOA SƠ SINH VÀ HỒI SỨC SƠ SINH BỆNH VIỆN NHI ĐỒNG 2

Abstract

Objective: To describe the clinical, paraclinical characteristics and treatment outcomes of neonates with invasive Candida spp infection.Patients and Methods: This is a case-series study with retro-prospective data collection on all infants with invasive candidiasis treated at Children's Hospital 2 from April 11, 2021 to June 15, 2023. Results: There were 104 infants with invasive candidiasis with 106 episodes of infection during the study period, with a median gestational age of 31 [27; 36] weeks, a median birth weight of 1400 [1050; 2475] grams, and a median age at the onset of infection of 24.5 [17.0; 39.3] days. Common clinical and paraclinical symptoms were impaired consciousness, abdominal distension, malnutrition, cyanosis, fever; increased CRP and thrompocytopenia, leukopenia. The most common Candida species was C. parapsilosis (44.3%), followed by C. albicans (32.%), with co-bacterial infection during candidiasis was 29.8%. The most common underlying diseases were sepsis caused by bacteria 41.3%, congenital abnormalities in the gastrointestinal tract 31.7%. The most common risk factors for candidiasis were previous antibiotic use (100%), parenteral nutrition (90.4%), followed by the presence of a central venous catheter (CVC) (70.2%). Treatment with amphotericin B had the highest rate at 59.6%, while the combination of amphotericin B and fluconazole was used in 34.6% of cases. The overall in-hospital mortality rate was 35.6%. Conclusions: The overall mortality rate of neonates with invasive candidiasis remains high. Antifungal therapy is mainly monotherapy with amphotericin B. Invasive candidiasis risk factors were quite prevalent, need more studies to identify an independent association with mortality.