早产儿念珠菌感染课件

早产儿念珠菌感染早产儿念珠菌感染1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提要2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简要背景3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:<1%Pediatrics.2019117:8492ELBW中更为常见生后72h血培养或CsF培养念珠菌阳性率6.9%Pediatrics2019Jan;117(1):84>ELBW念珠菌感染率:7%-20%CurrOpinnfectDis2019Dec:20(6):592ELBW念珠菌感染率:9%Pediatrics2019Oct:126(4e865年发病率:439/10000新生儿Australia,2019-201997%病例诊断为住院新生儿Pediatrics2009May:123(5):1360总体发病率:15病例/10,000住院新生儿(95%C|:13-16/10,000)ClinInfectDis2019May1:44(9):1187流行病学资料4流行病学资料+2019意大利资料:6NCUs监测:总发病率:13%,n=1597VLBW4%,n=248ELBW4.7%,n=171LBW0.2%IIFInddenceIn6NICUsIndudedinthesurveillanceNICUsNoofbedsNoadmittedNo(%)IFlsIncidence/100admitted2407033,42.9ABcDEF6o88482204(190182803(14.33313014.32592(9.52(9.5Total159721t0o》1.3Jprevmedhyg2019:51:125-7s0流行病学资料5流行病学资料+中国NCUs多中心调查资料2009~2019,发病率centerBedsDischarCaseCase%casesPretermLBWVLBW1340302249080.7711.56B418703128140.256930.8716167240.242250.8912289630.2113352181260.3314750.0014173304060.4739501042.631.90367726710.410.134053386190.560.193374.1528180.180.00334Total444300452230.74213340.4536433.32HPXia.XZhou,JXZhu,etalMu/-centercinicalsurveyofCandidainfectionintheNCUsinthethreeyearsduring2009to2019inChina:Unpubishedc流行病学资料6主要菌株+australia,年龄<1月菌株%Candidaalbicans白色Candidaparapsilosis近平滑42.4Candidaglabrata光滑CandidatropicalIs热带Candidadubliniensis杜比333Polycandidal多重Pediatrics2009May:123(5):1360主要菌株7主要菌株+中国NCUs多中心调查资料2009~2019,主要菌株菌株(%)200920192019overallCandidaalbicans白色86.456.751.6Candidaparapsilosis近平滑2.31433.08.5Candidaglabrata光滑2.3179193Candidatropicalis热带6.82.715Candidaguilliermondi季也蒙0.0410.45.8Candidafamata无名0.04.57.54.5Candidahumicola土生隐球酵母0.00.004Candidakruse克柔0.00.01504Candidalusitaniae葡萄牙0.01.80.00.9Others:Debaryomycesetchellsii,etc.2.30.01.50.9multiplecandidacases:5HPXia.XYZhou,JXZ,etalMu-centercinicalsurveyofCandidainfectionintheNCUsinthethreeyearsduring2009to2019inChina:主要菌株8发生念珠菌感染的独立危险圆素+ELBW队列研究:USNICHD,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<750g322,247-4.19<0001头孢菌素应用177,1.31-238<.0002无肠内喂养肠内喂养0.57,0420.79,p<0006男性126,1.01-1.62<0443Pediatrics2019Jan:117(1):84发生念珠菌感染的独立危险圆素9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(1.37~286)0003中心静脉置管1.94(1.17~321)0098静脉应用脂肪酸1.66(0.98~281).0596气管插管1.58(1.07~235)0226出生前皮质激素1.40(0.97~2.03)0747Pediatrics2019Ocf:126(4)发生念珠菌感染的相关危险因素10早产儿念珠菌感染课件11早产儿念珠菌感染课件12早产儿念珠菌感染课件13早产儿念珠菌感染课件14早产儿念珠菌感染课件15早产儿念珠菌感染课件16早产儿念珠菌感染课件17早产儿念珠菌感染课件18早产儿念珠菌感染课件19早产儿念珠菌感染课件20早产儿念珠菌感染课件21早产儿念珠菌感染课件22早产儿念珠菌感染课件23早产儿念珠菌感染课件24早产儿念珠菌感染课件25早产儿念珠菌感