抗真菌预防-我们今天在哪里?
1University of Virginia Children's Hospital, Charlottesville, VA, 22908, USA.
Seminars in fetal & neonatal medicine
|November 9, 2025
概括
侵入性坎迪达菌感染 (ICI) 影响过早出生的婴儿,原因是免疫力不成熟. 向性可纳预防有效地预防高风险极低出生体重婴儿的ICI.
科学领域:
- 新生儿医学 新生儿医学
- 传染性疾病 传染性疾病
- 儿科重症监护 儿科重症监护
背景情况:
- 侵入性Candida感染 (ICI) 对早产婴儿,特别是较低妊娠年龄 (GA) 的婴儿越来越令人担忧.
- 不成熟的免疫系统和发达不足的障碍物增加了新生儿对ICI的敏感性.
- 高死亡率和神经发育障碍 (NDI) 在极低出生体重 (ELBW) 的ICI婴儿中持续存在.
研究的目的:
- 审查在早产婴儿中侵袭性坎迪达感染 (ICI) 的发生率,危险因素和预防策略.
- 评估在高风险ELBW婴儿中使用可纳预防的疗效和安全性.
- 突出需要在不同妊娠年龄段对ICI进行标准化定义和报告.
主要方法:
- 对过早出生婴儿的侵入性Candida感染 (ICI) 现有文献的综述.
- 分析关于在极低出生体重 (ELBW) 婴儿的弗卢可纳预防疗法的有效性和安全性的数据.
- 确定与ICI发展和结果相关的关键风险因素.
主要成果:
- 每周两次的向可纳预防 (3或6毫克/公斤) 对于预防高危ELBW婴儿的ICI是有效和安全的.
- 可纳的预防作用比尼斯塔丁更有效,可以静脉注射,不管食状况如何.
- 确定的危险因素包括使用抗生素,肠外营养,中央静脉导管,阴道分娩,特定的类/碳类药物和胃肠道疾病.
结论:
- 可纳预防是预防高危ELBW婴儿ICI的推策略.
- 标准化ICI定义和报告对于准确评估率和结果至关重要.
- 早期识别高风险婴儿和及时的抗真菌预防可以改善结果.
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