The clinical characteristics of fungal bloodstream infection in premature infants 37 cases

Background: Premature infants fungal infections are common cause of morbidity and mortality in the NICU. Few studies have been done on clinical features of premature infants fungal infection. This paper focuses on the clinical characteristics. Methods: A retrospective study was conducted to describe 37 cases of fungal bloodstream infection in premature infants, compared with the laboratory data (Complete blood count, CRP, Liver function, Biochemical, Electrolytes, Blood gas analysis) at 3 different time points that was hospital admission, suspected fungal infections and anti-fungal treatment for 2 weeks. One-way ANOVA was used for analysis. If equal variances assumed, LSD was performed for multiple comparisons. Equal variances not assumed, with Tamhane's T2 method for multiple comparisons. Results: The mean time 17 days after preterm infants birth were predisposed to fungal infections. The most common species isolated from these premature infants was Candida albicans (35.1%), followed by Candida parapsilosis (29.7%), Candida famata (10.8%). The clinical manifestations of fungal bloodstream infection in premature infants were platelet reduction, poor response, poor perfusion, respiratory rhythm and heart rate change, hypothermia, weight not increase, feeding intolerance, more sputum in mechanical ventilation, difficult to withdrawal ventilator, unexplained deterioration and so on. One-way ANOVA analysis results: Plat, HCT, MCV, MCH, PDW, MPV, CRP had significant difference, F values were: 18.008, 4.018, 44.619, 47.265, 8.834, 4.681, 8.151. Liver function: ALT, TBIL, CK, CKMB, ALB, LDH had significant difference, F values were: 8.937, 6.401, 13.446, 16.699, 3.331, 77.475. Only Ca2+ had significant difference in blood gas and electrolyte analysis, F = 6.292, p < 0.05. Drug susceptibility results showed only 3 cases of fluconazole-resistant. Conclusion: This study emphasizes that it highly suspect of fungal bloodstream infection to preterm infants who occurs non-specific manifestations of infectious illness, platelet reduction, CRP, PDW, MPV increase.