Vieira R A, Diniz E M A, Vaz F A C
Department of Pediatrics, Faculty of Medicine, University of São Paulo, Sao Paulo, Brazil.
J Matern Fetal Neonatal Med. 2003 May;13(5):341-50. doi: 10.1080/jmf.13.5.341.350.
To determine the prevalence of lower respiratory tract infection due to respiratory viruses in the neonatal period at admission to the neonatal intensive care unit and to compare the clinical, laboratory and radiological aspects of the clinical course, according to the etiological agent, in the neonatal period.
Ninety newborns were studied, from January 1999 to January 2001, with bronchiolitis and/or pneumonia. The newborns were classified into three groups, according to the etiological agent identified initially: viral infection (group A), mixed viral-bacterial infection (group B), and bacterial infection (group C).
The virus was identified in 72 newborns (80.0%); the most prevalent was respiratory syncytial virus (RSV) (44.4%), followed by influenza A virus (22.2%). Coughing, wheezing and an interstitial infiltrate were significantly more frequent in newborns with viral infection. Mixed infection was more associated with sepsis. There was a correlation between viral infection and low values of initial and subsequent white blood cell count and C-reactive protein. RSV was the most important virus in these patients.
It was observed that, although the majority of viral respiratory infections had a favorable course, some patients presented a serious and prolonged clinical manifestation, especially when there was concomitant bacterial infection.
确定新生儿重症监护病房收治的新生儿中,呼吸道病毒引起的下呼吸道感染的患病率,并根据病因,比较新生儿期临床病程的临床、实验室及影像学方面情况。
对1999年1月至2001年1月间90例患细支气管炎和/或肺炎的新生儿进行研究。根据最初确定的病因,将新生儿分为三组:病毒感染组(A组)、病毒-细菌混合感染组(B组)和细菌感染组(C组)。
72例新生儿(80.0%)检测出病毒;最常见的是呼吸道合胞病毒(RSV)(44.4%),其次是甲型流感病毒(22.2%)。病毒感染的新生儿咳嗽、喘息及间质浸润更为常见。混合感染与败血症关联更大。病毒感染与初始及后续白细胞计数和C反应蛋白低值之间存在相关性。RSV是这些患者中最重要的病毒。
观察到,尽管大多数病毒性呼吸道感染病程良好,但部分患者出现严重且迁延的临床表现,尤其是合并细菌感染时。