中国当代儿科杂志2024，Vol.26Issue(10)：1086-1092,7.DOI:10.7499/j.issn.1008-8830.2406021
儿童急性白血病化疗后合并真菌血流感染的临床特征及预后分析
Clinical features and prognosis of children with fungal bloodstream infection following chemotherapy for acute leukemia
翁开枝 1吴椿萍 2庄树铨 3黄淑贤 1王晓芳 3郑湧智2
作者信息
- 1. 福建医科大学附属漳州市医院儿童血液风湿肾科,福建漳州 363000
- 2. 福建医科大学附属协和医院小儿血液科/福建省血液病研究所/福建省血液病学重点实验室,福建福州 350001
- 3. 福建医科大学附属泉州第一医院儿科,福建泉州 362000
- 折叠
摘要
Abstract
Objective To investigate the clinical features and prognosis of children with fungal bloodstream infection(BSI)following chemotherapy for acute leukemia(AL).Methods A retrospective analysis was performed on 23 children with fungal BSI following chemotherapy for AL in three hospitals in Fujian Province,China,from January 2015 to December 2023.Their clinical features and prognosis were analyzed.Results Among all children following chemotherapy for AL,the incidence rate of fungal BSI was 1.38%(23/1 668).At the time of fungal BSI,87%(20/23)of the children had neutrophil deficiency for more than one week,and all the children presented with fever,while 22%(5/23)of them experienced septic shock.All 23 children exhibited significant increases in C-reactive protein and procalcitonin levels.A total of 23 fungal isolates were detected in peripheral blood cultures,with Candida tropicalis being the most common isolate(52%,12/23).Caspofungin or micafungin combined with liposomal amphotericin B had a relatively high response rate(75%,12/16),and the median duration of antifungal therapy was 3.0 months.The overall mortality rate in the patients with fungal BSI was 35%(8/23),and the attributable death rate was 22%(5/23).Conclusions Fungal BSI following chemotherapy in children with AL often occurs in children with persistent neutrophil deficiency and lacks specific clinical manifestations.The children with fungal BSI following chemotherapy for AL experience a prolonged course of antifungal therapy and have a high mortality rate,with Candida tropicalis being the most common pathogen.关键词
侵袭性真菌病/血流感染/急性白血病/抗真菌治疗/预后/儿童Key words
Invasive fungal disease/Bloodstream infection/Acute leukemia/Antifungal therapy/Prognosis/Child引用本文复制引用
翁开枝,吴椿萍,庄树铨,黄淑贤,王晓芳,郑湧智..儿童急性白血病化疗后合并真菌血流感染的临床特征及预后分析[J].中国当代儿科杂志,2024,26(10):1086-1092,7.
