摘要
背景肠道病毒(EV)是导致新生儿感染的常见病原体之一,了解住院新生儿EV核酸检测的阳性率及疾病分布情况有助于制定合理的治疗方案。目的探讨新生儿内科住院患儿入院时肠道病毒(EV)咽拭子核酸检测的阳性率及疾病分布状况。设计横断面研究。方法对2020年10月至2021年9月在首都医科大学附属北京儿童医院新生儿内科住院的患儿,于入院当天采集咽拭子,采用CA16、EV71、EV通用型核酸三重实时荧光PCR检测试剂盒进行EV核酸检测。计算EV核酸检测阳性率,统计疾病分布情况,并比较EV阳性组与阴性组新生儿的临床表现和实验室指标差异。主要结局指标住院新生儿EV核酸检测的阳性率及疾病分布情况。结果①共纳入1095例新生儿(占同期住院新生儿的91.2%),其中男婴605例(55.3%),足月儿976例(89.1%),入院中位日龄为11(4,19)d,第一入院诊断的前3顺位为新生儿病理性黄疸、新生儿肺炎、新生儿感染,住院中位时间为8(6,12)d。②EV核酸检测阳性检出率为9.1‰(10/1095),感染性疾病患儿中EV核酸阳性检出率为18.6‰(9/483)。以呼吸道症状(5例)、黄疸(3例)和消化道症状(2例)为首发症状。10例均治愈或好转出院。③EV阳性组和阴性组在性别、出生体重、出生胎龄、是否早产、分娩方式、喂养方式、母亲存在围生期感染高危因素、母妊娠期糖尿病、发病日龄、住院时间、住院费用等方面差异均无统计学意义(P>0.05)。EV阳性组(60.0%)在发病前感染接触史的发生率高于EV阴性组(7.0%);EV阳性组中枢神经系统感染(20.0%)高于EV阴性组(3.1%);差异均有统计学意义。EV阳性组感染性疾病患儿比例(90.0%)高于阴性(43.7%)但差异无统计学意义;发热、病理性黄疸、呼吸道症状、消化道症状、神经系统症状的发生率在两组差异均无统计学意义(P>0.05)。④EV阳性组和阴性组血WBC总数、Hb、PLT减少发生率、心肌酶和ALT
Background Enterovirus(EV)is one of the common pathogens that cause neonatal infection.Understanding the positive rate of EV nucleic acid detection and the disease distribution of hospitalized newborns will facilitate the development of rational therapeutic strategies.Objective To investigate the positive rate of enterovirus nucleic acid swabs in hospitalized neonates and its distribution in diseases.Design A cross-sectional study.Methods For patients hospitalized in neonatal medical ward at Beijing Children′s Hospital from October 1,2020 to September 30,2021,the throat swabs were taken on the day of admission.Real-time PCR was used to detected general enterovirus(EV)-EV71/CA16(Coxsackievirus A16).The positive rate of EV nucleic acid test and its distribution in disease was calculated.Clinical manifestations and laboratory tests between the EV positive group and the negative group were compared.Main outcome measures Positive rate of EV nucleic acid detection and disease distribution in hospitalized neonates.Results A total of 1,095 neonates(accounting for 91.2%of the hospitalized patients during the same period)were enrolled,including 605 males(55.3%)and 976 term infants(89.1%).The median age of admission was 11(4-19)days and the median hospital stay was 8(6-12)days.The first three orders of admission diagnosis were neonatal hyperbilirubinemia,neonatal pneumonia,and neonatal septicemia.The positive rate of EV nucleic acid test was 9.1‰(10/1095).The positive rate of EV nucleic acid in infectious diseases was(9/483,18.6‰).Among them,5 cases(50%),3 cases(30%)and 2 cases(20%)were presented with respiratory symptoms,jaundice and gastrointestinal symptoms as the first symptoms,respectively.Ten children were cured or improved and discharged.There were no statistically significant differences between children with positive and negative EV nucleic acid tests in gender,birth weight,gestational age,preterm delivery,delivery mode,feeding mode,maternal risk factors of perinatal infection,maternal gestational diabetes,ag
作者
徐海冬
陈祥鹏
王红
李奇
史明睿
覃菲
谢正德
黑明燕
XU Haidong;CHEN Xiangpeng;WANG Hong;LI Qi;SHI Mingrui;QIN Fei;XIE Zhengde;HEI Mingyan(Department of Neonatology,Neonatal Center,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Laboratory of Infection and Virology,Beijing Pediatric Research Institute,Beijing 100045,China;Research Unit of Critical Infection in Children,Chinese Academy of Medical Sciences,Beijing 100045,China)
出处
《中国循证儿科杂志》
CSCD
北大核心
2023年第2期114-118,共5页
Chinese Journal of Evidence Based Pediatrics
基金
北京市卫生健康委员会首都卫生发展科研专项课题:#2022-2-2095
北京市自然科学基金-海淀原始创新联合基金重点研究专题:L192014。
关键词
肠道病毒感染
临床特征
新生儿
Enterovirus infection
Clinical features
Infant
