본문 바로가기
KERD
논문KCI 등재

극소 미숙아에서 침습 칸디다 감염

Invasive Candida Infections in Extremely Preterm Infants

김천수|이상락
대한신생아학회 (THE KOREAN SOCIETY OF NEONATOLOGY)|2013.08|Neonatal medicine|제20권 제3호|pp. 367-374

1

조회

0

다운로드

1

인용

0

참고문헌

키워드

InfectionInfantsCandidaExtremely premature

초록

Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among extremely preterm infants in the neonatal intensive care unit. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Factors such as exposure to broad spectrum antimicrobials, especially third generation cephalosporin, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery increase the risk of invasive infection. A definite diagnosis of ICI requires isolation the organism from blood or other sterile body fluid. Thrombocytopenia is very common in neonatal candidiasis, but it is also often seen in babies with bacteremia. Candida is capable of invading all vital organs and following candidemia, therefore a thorough evaluation to rule out end organ dissemination is important. Amphotericin-B is the drug of choice for treating ICI. Antifungal susceptibility test is increasingly used to manage ICI, especially in situations refractory to initial antifugal therapy. Invasive candidiasis among extremely preterm infants is associated with chronic lung disease,severe retinopathy of prematurity, and neurodevelopmental impairment at infancy.

Abstract

Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among extremely preterm infants in the neonatal intensive care unit. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Factors such as exposure to broad spectrum antimicrobials, especially third generation cephalosporin, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery increase the risk of invasive infection. A definite diagnosis of ICI requires isolation the organism from blood or other sterile body fluid. Thrombocytopenia is very common in neonatal candidiasis, but it is also often seen in babies with bacteremia. Candida is capable of invading all vital organs and following candidemia, therefore a thorough evaluation to rule out end organ dissemination is important. Amphotericin-B is the drug of choice for treating ICI. Antifungal susceptibility test is increasingly used to manage ICI, especially in situations refractory to initial antifugal therapy. Invasive candidiasis among extremely preterm infants is associated with chronic lung disease,severe retinopathy of prematurity, and neurodevelopmental impairment at infancy.

참고문헌 (49)

  1. Stoll BJ, "Late-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network", J Pediatr, 129, pp.63~71 (1996)
  2. Stoll BJ, "Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network", Pediatrics, 110, pp.285~291 (2002)
  3. Kaufman DA, "Epidemiology and prevention of neonatal candidiasis: fluconazole for all neonates?", Adv Exp Med Biol, 659, pp.99~119 (2010)
  4. Kaufman D, "Fungal infection in the very low birth weight infant", Curr Opin Infect Dis, 17, pp.253~259 (2004)
  5. Kaufman D, "Clinical microbiology of bacterial and fungal sepsis in very-low-birth-weight infants", Clin Microbiol Rev, 17, pp.638~680 (2004)
  6. Benjamin DK Jr, "Neonatal candidemia and end-organ damage: a critical appraisal of the literature using meta-analytic techniques", Pediatrics, 112, pp.634~640 (2003)
  7. Benjamin DK Jr, "Neonatal candidiasis among extremely low birth weight infants: risk factors, mortality rates, and neurodevelopmental outcomes at 18 to 22 months", Pediatrics, 117, pp.84~92 (2006)
  8. Zaoutis TE, "Outcomes attributable to neonatal candidiasis", Clin Infect Dis, 44, pp.1187~1193 (2007)
  9. Kaufman D, "Fluconazole prophylaxis against fungal colonization and infection in preterm infants", N Engl J Med, 345, pp.1660~1666 (2001)
  10. Kicklighter SD, "Fluconazole for prophylaxis against candidal rectal colonization in the very low birth weight infant", Pediatrics, 107, pp.293~298 (2001)
  11. Kaufman DA, "Patterns of fungal colonization in preterm infants weighing less than 1000 grams at birth", Pediatr Infect Dis J, 25, pp.733~737 (2006)
  12. Baley JE, "Fungal colonization in the very low birth weight infant", Pediatrics, 78, pp.225~232 (1986)
  13. Huang YC, "Outbreak of Candida parapsilosis fungemia in neonatal intensive care units: clinical implications and genotyping analysis", Infection, 27, pp.97~102 (1999)
  14. Clark TA, "Epidemiologic and molecular characterization of an outbreak of Candida parapsilosis bloodstream infections in a community hospital", J Clin Microbiol, 42, pp.4468~4472 (2004)
  15. O’Grady NP, "Guidelines for the prevention of intravascular catheter-related infections", Clin Infect Dis, 52, pp.e162~e193 (2011)
  16. Borghesi A, "Strategies for the prevention of hospital- acquired infections in the neonatal intensive care unit", J Hosp Infect, 68, pp.293~300 (2008)
  17. Garland JS, "Strategies to prevent bacterial and fungal infection in the neonatal intensive care unit", Clin Perinatol, 36, pp.1~13 (2009)
  18. Chapman RL, "Persistently positive cultures and outcome in invasive neonatal candidiasis", Pediatr Infect Dis J, 19, pp.822~827 (2000)
  19. Noyola DE, "Ophthalmologic, visceral, and cardiac involvement in neonates with candidemia", Clin Infect Dis, 32, pp.1018~1023 (2001)
  20. 김지영, "신생아에서 칸디다 뇌막염의 임상적 특징 및 초음파검사의 유용성", Infection and Chemotherapy, 37(5), pp.280~287 (2005), 대한감염학회
  21. Kinney HC, "Perinatal neuropathology, In Greenfield’s neuropathology", pp.519~606 (2002), Arnold
  22. Nolte J, "The human brain: An introduction its functional anatomy", pp.98~118 (2002), Mosby
  23. Volpe JJ, "Neurology of the newborn", pp.774~810 (2001), WB Saunders Co
  24. Karlowicz MG, "Candidal renal and urinary tract infection in neonates", Semin Perinatol, 27, pp.393~400 (2003)
  25. 최보금, "신생아에서 칸디다 패혈증에 합병된 신균종의 임상적 특징 및 예후", Neonatal medicine, 19(4), pp.237~244 (2012), 대한신생아학회
  26. Kim DH, "Systemic candidiasis in neonatal intensive care unit: an 8-year experience", J Korean Soc Neonatol, 8, pp.33~45 (2001)
  27. Pickering LK, "Red Book: 2012 Report of the Committee on Infectious Diseases", pp.265~830 (2012), AAP
  28. Schelonka RL, "Time to positive culture results in neonatal Candida septicemia", J Pediatr, 142, pp.564~565 (2003)
  29. Arjuna N.B. Ellepola, "Laboratory Diagnosis of Invasive Candidiasis", The Journal of Microbiology, 43(s), pp.65~84 (2005), 한국미생물학회
  30. Guida JD, "Platelet count and sepsis in very low birth weight neonates: is there an organism-specific response?", Pediatrics, 111, pp.1411~1415 (2003)
  31. Isaacs D, "Handbook of neonatal infections", pp.283~301 (2000), WB Saunders Co
  32. Fernandez M, "Candidal meningitis in neonates: a 10-year review", Clin Infect Dis, 31, pp.458~463 (2000)
  33. Benjamin DK Jr, "Candidal mycetoma in the neonatal kidney", Pediatrics, 104, pp.1126~1129 (1999)
  34. 한혜영, "조산아에서 삼첨판막의 증식조직을 보인 칸디다성 심내막염 1례 -수술적 제거 및 항진균제 치료의 성공적 치험", Korean Journal of Pediatrics, 43(6), pp.832~836 (2000), 대한소아과학회
  35. Zaoutis TE, "Antifungal treatment in pediatric patients", Drug Resist Updat, 8, pp.235~245 (2005)
  36. Caudle KE, "Echinocandin use in the neonatal intensive care unit", Ann Pharmacother, 46, pp.108~116 (2012)
  37. Kicklighter SD, "Antifungal agents and fungal prophylaxis in the neonate", NeoReviews, 3, pp.e249~e255 (2002)
  38. Pappas PG, "Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America", Clin Infect Dis, 48, pp.503~535 (2009)
  39. Baley JE, "Pharmacokinetics, outcome of treatment, and toxic effects of amphotericin B and 5-fluorocytosine in neonates", J Pediatr, 116, pp.791~797 (1990)
  40. Driessen M, "Fluconazole vs. amphotericin B for the treatment of neonatal fungal septicemia: a prospective randomized trial", Pediatr Infect Dis J, 15, pp.1107~1112 (1996)
  41. Mora-Duarte J, "Comparison of caspofungin and amphotericin B for invasive candidiasis", N Engl J Med, 347, pp.2020~2029 (2002)
  42. Nucci M, "Should vascular catheters be removed from all patients with candidemia? An evidence-based review", Clin Infect Dis, 34, pp.591~599 (2002)
  43. Karlowicz MG, "Should central venous catheters be removed as soon as candidemia is detected in neonates?", Pediatrics, 106, pp.E63~ (2000)
  44. Greenberg RG, "Empiric antifungal therapy and outcomes in extremely low birth weight infants with invasive candidiasis", J Pediatr, 161, pp.264~269 (2012)
  45. Makhoul IR, "Epidemiological, clinical, and microbiological characteristics of late-onset sepsis among very low birth weight infants in Israel: a national survey", Pediatrics, 109, pp.34~39 (2002)
  46. 최진혁, "신생아 집중치료실 환아에서 감염 초기에 치명적 경과를 보인 후기 발현 패혈증의 임상적 특징 및 초기 항균요법의 영향", 대한주산의학회잡지, 22(4), pp.329~336 (2011), 대한주산의학회
  47. Faix RG, "Invasive neonatal candidiasis: comparison of albicans and parapsilosis infection", Pediatr Infect Dis J, 11, pp.88~93 (1992)
  48. Friedman S, "Systemic Candida infection in extremely low birth weight infants: short term morbidity and long term neurodevelopmental outcome", Pediatr Infect Dis J, 19, pp.499~504 (2000)
  49. Adams-Chapman I, "Neurodevelopmental outcome of extremely low birth weight infants with Candida infection", J Pediatr (2013)

관련 논문AI추천

신생아 집중치료실에서 침습 칸디다 감염의 예방김천수대한소아감염학회 · Pediatric Infection and Vaccine2011 · 제18권 제1호극소 저체중 출생아에서 전신성 칸디다 감염 : 5년간의 역학적 특성성인경, 이승우, 이정은, 이정현, 이주영, 이현승대한신생아학회 · Neonatal medicine2009 · 제16권 제2호신생아 집중치료실에서 진균감염의 예방최영륜대한신생아학회 · Neonatal medicine2013 · 제20권 제3호출생 체중 1 kg 미만의 초 극소 저 체중 출생아에서 침습성 진균 감염증에 대한 Fluconazole 예방 요법의 효과 분석곽혜선, 김재연, 박윤희, 양사미, 임혜민, 한혜원한국병원약사회 · 병원약사회지2014 · 제31권 제4호The Incidence, Treatment and Risk Factors of Candidiasis in Very Low Birth Weight InfantsDa Young Yun, Ha Young Shin, Hyun A Park, Jina Park, Jong Hee Hwang, Yun Hye Shin대한신생아학회 · Neonatal medicine2016 · 제23권 제1호A Comparison of AmBisome(R) to Amphotericin B for Treatment of Systemic Candidiasis in Very Low Birth Weight Infants장욱, 구수현, 김성신, 박원순, 이은경, 이장훈, 장윤실, 전가원, 황종희연세대학교의과대학 · Yonsei Medical Journal2007 · 제48권 제4호

이 간행물의 다른 논문 (17건)

대한신생아학회 창립 20주년을 기념하며남궁란pp. 233-233한국에서 신생아 집중치료 역사의 이정표최중환pp. 234-246한국 신생아역학 최근 30년간의 변화최용성, 배종우, 정성훈pp. 247-255초미숙아 생존 한계 극복 방안장윤실, 박원순pp. 256-265빌리루빈 대사와 빌리루빈 뇌증이철, 이순민, 남궁란pp. 266-273
원문 보기