ĐẶC ĐIỂM NHIỄM NẤM HUYẾT Ở TRẺ SƠ SINH TẠI BỆNH VIỆN NHI ĐỒNG 1

Abstract

Background: Fungaemia is defined as when the patient's blood culture results show that the causative agent is a fungus. In Vietnam, the death rate due to Candida in newborns according to studies in recent years is quite high, ranging from about 25% - 45%. Research on fungal sepsis in neonates is limited, the profile of fungal pathogens has changed over the time and drug resistance has been increased. Methods: Case series from January 2020 to July 2024 at Children's Hospital 1. Results: There were 36 infants with invasive candidiasis during the study period, with a median gestational age of 32.7 (28.8 – 36.5) weeks, a median birth weight of 2055 (1100 – 2900) grams, and a median age at the onset of infection of 20.0 (10.0 – 30.0) days. Common clinical and paraclinical symptoms were impaired consciousness, abdominal distension, cyanosis; increased CRP and thrompocytopenia. The most common Candida species was C. parapsilosis (52.8%), followed by C. albicans (25.0%), with co-bacterial infection during candidiasis was 25.0%. The most common risk factors for candidiasis were previous antibiotic use (97.2%), parenteral nutrition (97.2%), endotracheal intubation (97.2%), followed by the presence of a central venous catheter (CVC) (77.8%). Treatment combination of amphotericin B and fluconazole had the highest rate at 41.9%, while amphotericin B was used in 35.6% of cases. The overall in-hospital mortality rate was 44.4%. Conclusion: The overall mortality rate of neonates with invasive candidiasis remains high. Antifungal therapy is combination of amphotericin B and fluconazole. Invasive candidiasis risk factors were quite prevalent, need more studies to identify an independent association with mortality.