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[巨细胞病毒:呼吸窘迫综合征婴儿的先天性感染及临床表现]

[Cytomegalovirus: congenital infection and clinical presentation in infants with respiratory distress syndrome].

作者信息

Martínez-Contreras Angélica, Lira Rosalía, Soria-Rodríguez Carmen, Hori-Oshima Sawako, Maldonado-Rodríguez Angélica, Rojas-Montes Othón, Ayala-Figueroa Rafael, Estrada-Guzmán Julia, Álvarez-Muñoz Ma Teresa

机构信息

Unidad de Cuidados Intensivos Neonatales, Hospital de Gineco-Pediatría y Medicina Familiar 31, Instituto Mexicano del Seguro Social (IMSS), Mexicali, Baja California.

出版信息

Rev Med Inst Mex Seguro Soc. 2015 May-Jun;53(3):286-93.

Abstract

BACKGROUND

Respiratory distress syndrome (RDS) is a multifactorial and common disease that varies from 15 to 50 % in the newborn, causing 50 % of mortality. The RDS may be associated with bacterial and viral infections, and one of the most common viral agents is the cytomegalovirus (CMV). In the neonatal period the virus incidence goes from 0.4 to 2.5 % with a seroprevalence of 50 to 75 %; the incidence of infection in newborn with RDS is unknown. The objective was to determine the frequency of CMV infection in neonates with RDS and identify the risk factors associated with infection.

METHODS

The CMV-DNA was identified in plasma by quantitative PCR; maternal and neonatal variables that defined the clinical findings were analyzed by logistic regression.The CMV-DNA was identified in plasma by quantitative PCR; maternal and neonatal variables that defined the clinical findings were analyzed by logistic regression.

RESULTS

The frequency of CMV infection in 197 infants with RDS was 8.6 % (95 % CI, 4.7-12.5). The significant variables in newborn were: neutropenia (p = 0.012), thrombocytopenia (p = 0.021), mottled skin (p = 0.03), and the maternal significant variable was cervicovaginitis (p = 0.05).

CONCLUSIONS

We reported for the first time the highest frecuency of CMV infection in newborns with RDS and the association of various risk factors with CMV infection.

摘要

背景

呼吸窘迫综合征(RDS)是一种多因素的常见疾病,在新生儿中的发病率为15%至50%,死亡率达50%。RDS可能与细菌和病毒感染有关,最常见的病毒病原体之一是巨细胞病毒(CMV)。在新生儿期,该病毒的发病率为0.4%至2.5%,血清阳性率为50%至75%;RDS新生儿的感染发病率尚不清楚。目的是确定RDS新生儿中CMV感染的频率,并识别与感染相关的危险因素。

方法

通过定量PCR在血浆中鉴定CMV-DNA;通过逻辑回归分析定义临床发现的母体和新生儿变量。

结果

197例RDS婴儿中CMV感染的频率为8.6%(95%CI,4.7 - 12.5)。新生儿中的显著变量为:中性粒细胞减少(p = 0.012)、血小板减少(p = 0.021)、皮肤斑纹(p = 0.03),母体的显著变量为宫颈阴道炎(p = 0.05)。

结论

我们首次报告了RDS新生儿中CMV感染的最高频率以及各种危险因素与CMV感染的关联。

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