Bagci Soyhan, Eis-Hübinger Anna M, Franz Axel R, Bierbaum Gabriele, Heep Axel, Schildgen Oliver, Bartmann Peter, Kupfer Bernd, Mueller Andreas
Department of Neonatology, Children's Hospital, University of Bonn, Bonn, Germany.
Pediatr Infect Dis J. 2008 Apr;27(4):347-50. doi: 10.1097/INF.0b013e318162a17a.
Necrotizing enterocolitis (NEC) is a major cause of mortality and morbidity in very low birth weight infants (<1500 g birth weight). Although the etiology remains unknown, infectious agents could play a key role. The aim of this analysis was to examine the role of human astrovirus (HAstV) in infants with NEC.
All patients admitted during a 5-year period at a tertiary neonatal intensive care unit with NEC (Bell stage I-III) who had examination of stool specimens for bacterial and for viral infections were included. Clinical data were reviewed and compared between infants with NEC and astrovirus detection (NEC + HAstV) and infants with NEC without astrovirus detection (NEC - HAstV) in stool specimens.
Forty infants with NEC were identified between 2002 and 2006 and 8 patients were excluded from statistical evaluation because of incomplete viral examinations. HAstV was detected in stool specimens of 6 (19%) of the remaining 32 patients with NEC. Double infection with rotavirus was identified in 1 patient. No other viruses were detected. Significant differences in patients with NEC - HAstV and NEC + HAstV were only shown for age at onset of illness (P < 0.001) but not for severity of illness, need for surgical intervention, or mortality.
This study demonstrates that HAstV may be associated with the development of NEC in a subgroup of patients and provides further evidence for the important role of gastrointestinal viral infections in this most common gastrointestinal emergency in premature infants. HAstV should be included in microbiological examination of stool specimens in patients with NEC.
坏死性小肠结肠炎（NEC）是极低出生体重儿（出生体重<1500克）死亡和发病的主要原因。尽管病因尚不清楚，但感染因素可能起关键作用。本分析的目的是研究人星状病毒（HAstV）在NEC患儿中的作用。
纳入一家三级新生儿重症监护病房5年内收治的所有患有NEC（贝尔分期I-III期）且粪便标本进行了细菌和病毒感染检测的患者。回顾并比较了粪便标本中检测到星状病毒的NEC患儿（NEC+HAstV）和未检测到星状病毒的NEC患儿（NEC-HAstV）的临床资料。
2002年至2006年间共确定40例NEC患儿，8例因病毒检查不完整被排除在统计评估之外。其余32例NEC患儿中，6例（19%）粪便标本检测到HAstV。1例患儿同时感染轮状病毒。未检测到其他病毒。NEC-HAstV组和NEC+HAstV组在发病年龄上有显著差异（P<0.001），但在疾病严重程度、手术干预需求或死亡率方面无显著差异。
本研究表明，HAstV可能与部分NEC患儿的发病有关，并为胃肠道病毒感染在早产儿最常见的胃肠道急症中的重要作用提供了进一步证据。NEC患儿的粪便标本微生物检查应包括HAstV检测。
