KẾT QUẢ ĐIỀU TRỊ NHIỄM NẤM CANDIDA XÂM LẤN Ở TRẺ SƠ SINH TẠI BỆNH VIỆN NHI ĐỒNG 2

Abstract

Introduction: Invasive Candida infections (ICI) represent a significant health burden in Neonatal Intensive Care Units (NICU), contributing substantially to neonatal morbidity and mortality. Challenges in early diagnosis and treatment are notable, and data on the outcomes of such infections in Vietnam are sparse. This study evaluates the consequences of ICIs among neonates. Methods: This retrospective case series utilized medical records from neonates diagnosed with ICI in the Neonatal Department and NICU of Children's Hospital 2 from April 2021 to June 2023. Results: A total of 104 neonates were diagnosed with ICI, encompassing 106 episodes. The majority of these cases involved preterm infants (83 cases; 79.8%), with a median gestational age of 31.0 [27.0; 36.0] weeks and a birth weight of 1400g [1050; 2475]. The median age at diagnosis was 24.5 [17.0; 39.3] days. C. parapsilosis was the most frequently encountered species (48/106, 45.3%), followed by C. albicans (34/106, 32.0%). Isolated bloodstream infections were the most common manifestation, comprising 89.4% (93/104) of cases. The overall mortality rate was 35.6% (37/104), with the highest rates observed in neonates with extremely low birth weight (<1000g) at 50% (8/16), in those with birth weights ≥1000g at 33% (29/88), in cases with other sites beyond blood infection at 80% (4/5), in multi-site ICI (including bloodstream ICI) at 50% (3/6), and single bloodstream infection at 32.3% (30/93). Conclusion: ICI predominantly affects preterm neonates, with C. parapsilosis as the leading pathogen. The mortality associated with these infections is alarmingly high, especially in neonates with very low birth weights, multiple site infections, or non-bloodstream sites of infection, underscoring the need for targeted interventions and improved management protocols