新生儿重症监护病房中一组轮状病毒感染婴幼儿的临床表现。

Clinical manifestations of a cluster of rotavirus infection in young infants hospitalized in neonatal care units.

机构信息

Division of Pediatric Infectious Diseases, Chang Gung Memorial Hospital, Kweishan, Taoyuan, Taiwan.

出版信息

J Microbiol Immunol Infect. 2012 Feb;45(1):15-21. doi: 10.1016/j.jmii.2011.09.023. Epub 2011 Dec 11.

DOI:10.1016/j.jmii.2011.09.023

PMID:22154991

Abstract

PURPOSE

To define the clinical manifestations of rotavirus (RV) infection in neonates and young infants hospitalized in neonatal care units, which are rarely reported.

MATERIALS AND METHODS

From October 2008 to September 2010, a total of 153 stool specimens positive for RV were detected from 100 neonates and young infants hospitalized in neonatal care units of our hospital. Four infants had two episodes of RV infection. Demographics and clinical presentations of these infants were collected and analyzed. The infants were further classified as having hospital-acquired (HA) or community-acquired (CA) RV infection.

RESULTS

Of the 104 episodes from 100 patients, 76 (73%) were classified as HA. Fifty-six infants were male. The mean age of onset was 2 days. The most common presentations were loose stool passages (52.9%), abdominal distension (51.9%), blood or mucus in stool (42.3%), and unstable vital signs (32.7%). Watery character in stool passage was identified in 13.5% of the infants and vomiting in 21.2%. A picture suggestive of necrotizing enterocolitis (NEC) was identified in 22 episodes (21.1%), and 12 of these were stage II or above. The average number of hospitalization days from the onset of HA-RV infection was 23 days. Compared with those in the CA group, the infants in the HA group had a significantly higher rate of blood or mucus in stools (52.6% vs. 14.3%, p < 0.01) and unstable vital signs (39.5% vs. 14.3%, p = 0.02), but a lower rate of watery diarrhea (9.2% vs. 28.6%, p = 0.04) and fever (13.8% vs. 42.9%, p < 0.01). Overall, there were five deaths, but all of these infants had major diseases.

CONCLUSION

Bloody, mucoid stools and unstable vital signs, instead of fever with watery diarrhea, are commonly seen in neonates and young infants with RV infection. A substantial proportion of these infants may present as NEC. Once introduced, RV appears to become a troublesome problem of HA infections in neonatal care settings.

摘要

目的

明确在我院新生儿重症监护病房住院的新生儿和小婴儿轮状病毒（RV）感染的临床表现，此类感染很少见。

材料与方法

2008 年 10 月至 2010 年 9 月，从我院新生儿重症监护病房住院的 100 例新生儿和小婴儿的 153 份粪便标本中检测出 RV 阳性。其中 4 例患儿发生 2 次 RV 感染。收集并分析这些患儿的人口统计学和临床表现。将患儿进一步分为院内获得性（HA）和社区获得性（CA）RV 感染。

结果

100 例患儿的 104 例次中，76 例（73%）为 HA。56 例患儿为男性，发病的平均年龄为 2 天。最常见的表现为稀便（52.9%）、腹胀（51.9%）、粪便带血或黏液（42.3%）和生命体征不稳定（32.7%）。13.5%的患儿粪便呈水样，21.2%的患儿呕吐。22 例（21.1%）患儿表现出疑似坏死性小肠结肠炎（NEC）的特征，其中 12 例为 II 期或更高级别。HA-RV 感染发病至住院的平均天数为 23 天。与 CA 组相比，HA 组患儿粪便带血或黏液的发生率显著更高（52.6%比 14.3%，p<0.01）和生命体征不稳定的发生率更高（39.5%比 14.3%，p=0.02），但水样腹泻的发生率更低（9.2%比 28.6%，p=0.04）和发热的发生率更低（13.8%比 42.9%，p<0.01）。总体而言，共有 5 例死亡，但所有患儿均患有严重疾病。