RESUMEN
CNS candidosis is a severe disease, one of the nosocomial fungal infections, with often lethal issue or invalidation of the patient. Specific signs are absent and early diagnosis is very difficult. Risk factors are the following: prematurity, candidal carriage, prolonged hospitalization, treatment with broad spectrum antibiotics and immunosupressors, artificial pulmonary ventilation. No single effective antifungal agent exists. In the case of acute fungal CNS infection the drug of choice is fluconazole (diflucan) characterized by high efficacy and CSF sanitation rate, the drug is used intravenously with possible switching off to oral form. If the pathogen is not susceptible to the drug (C. crusel, C. glabrata and C. tropicalis) amphotericin B is recommended (C. lusitaniae is not susceptible). In the case of renal or hepatic failure AmBisome may be used as less toxic form. If the case of prolonged disease antifungal drugs are used in a long-term regime, drugs combinations are also recommended. Complex therapy with granulocyte colony stimulating factor may be used if the previous regime was not effective.
Asunto(s)
Candidiasis/diagnóstico , Infección Hospitalaria/diagnóstico , Meningitis/diagnóstico , Meningoencefalitis/tratamiento farmacológico , Candidiasis/tratamiento farmacológico , Candidiasis/microbiología , Candidiasis/transmisión , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/microbiología , Femenino , Humanos , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Meningitis/tratamiento farmacológico , Meningitis/microbiología , Meningoencefalitis/microbiología , Embarazo , Complicaciones Infecciosas del Embarazo/microbiología , Factores de RiesgoAsunto(s)
Antifúngicos/uso terapéutico , Micosis/tratamiento farmacológico , Anfotericina B/efectos adversos , Anfotericina B/uso terapéutico , Antifúngicos/efectos adversos , Candicidina/efectos adversos , Candicidina/uso terapéutico , Candida/efectos de los fármacos , Candida/aislamiento & purificación , Fluconazol/efectos adversos , Fluconazol/uso terapéutico , Humanos , Itraconazol/efectos adversos , Itraconazol/uso terapéutico , Miconazol/efectos adversos , Miconazol/uso terapéutico , Micosis/microbiología , Nistatina/efectos adversos , Nistatina/uso terapéuticoRESUMEN
The results of a 20-year microbiological monitoring of full-term newborns with infectious inflammatory diseases hospitalized from maternity homes of Moscow are presented. The incidence of candidiasis within that period was shown to increase 7 times at the account of the events of cutaneous and mucocutaneous candidiasis, gastrointestinal candidiasis and candidiasis of the central nervous system. One of the sources of the endogenic contamination of the newborns and infants was their intestinal microflora. In 4.6 per cent of the patients the meconium contamination by Candida was stated during the first days after the birth.