目的:比较临床特征,病毒血清型,中国三级新生儿重症监护病房轻度和重度肠病毒感染病例的结局。
方法:对2019年6月至8月住院病例进行回顾性分析。使用逆转录聚合酶链反应检查样品(粪便或咽喉拭子)。阳性病例分为轻度感染和重度感染两组。
结果:将149例患者分为轻度感染(n=104)和重度感染(n=45)两组之一。两组之间在性别方面没有显着差异,胎龄,出生体重,交货方式,并在7天内发病。两组的临床症状大多类似于败血症(发烧,皮疹,喂养不良,和嗜睡);然而,伴随症状如肝炎有显著差异,血小板减少症,脑炎,凝血病,和心肌炎.严重病例更有可能有异常的全血细胞计数,生化参数,和脑脊液标记.新生儿肠道病毒感染的主要血清型是回声病毒和柯萨奇病毒B。静脉注射免疫球蛋白,血管活性药物,经常需要输血,严重病例死亡率高。
结论:我们发现轻度和重度新生儿肠道病毒感染病例在并发症方面存在显著差异,实验室发现,和肠道病毒血清型。当新生儿出现败血症症状时,谨慎行事至关重要,在肠道病毒爆发期间。贫血,血小板减少症,肝功能异常,凝血功能障碍应密切监测,因为它们可能表明存在严重的肠病毒感染。
OBJECTIVE: To compare the clinical characteristics, virus serotype, and outcome in cases of mild and severe enteroviral infection at a tertiary neonatal intensive care unit in China.
METHODS: A retrospective analysis of cases hospitalized between June and August 2019. Samples (stool or throat swabs) were examined using reverse transcription polymerase chain reaction. Positive cases were divided into two groups: mild infection and severe infection.
RESULTS: A total of 149 cases were assigned to one of two groups: mild infection (n = 104) and severe infection (n = 45). There were no significant differences between the groups in terms of sex, gestational age, birth weight, mode of delivery, and onset within 7 days. Clinical symptoms in both groups mostly resembled sepsis (fever, rash, poor feeding, and lethargy); however, there were significant variations in concomitant symptoms such as hepatitis, thrombocytopenia, encephalitis, coagulopathy, and myocarditis. Severe cases were more likely to have abnormal complete blood counts, biochemical parameters, and cerebrospinal fluid markers. The predominant serotypes implicated in neonatal
enterovirus infections were echoviruses and Coxsackievirus B. Invasive ventilation, intravenous immunoglobulin, vasoactive medications, and blood product transfusions were often required, with high mortality rates among severe cases.
CONCLUSIONS: We found significant differences between mild and severe cases of neonatal
enterovirus infection with respect to complications, laboratory findings, and
enterovirus serotypes. It is crucial to exercise caution when newborns exhibit symptoms of sepsis, during an
enterovirus outbreak. Anemia, thrombocytopenia, abnormal liver function, and coagulation dysfunction should be monitored closely as they could indicate the presence of a severe enteroviral infection.