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住院期间及出院后早产儿的病毒性呼吸道感染

Viral Respiratory Infections in Preterm Infants during and after Hospitalization.

作者信息

Caserta Mary T, Yang Hongmei, Gill Steven R, Holden-Wiltse Jeanne, Pryhuber Gloria

机构信息

Department of Pediatrics, University of Rochester Medical Center, Rochester, NY.

Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY.

出版信息

J Pediatr. 2017 Mar;182:53-58.e3. doi: 10.1016/j.jpeds.2016.11.077. Epub 2016 Dec 30.

Abstract

OBJECTIVE

To determine the burden of viral respiratory infections in preterm infants both during and subsequent to neonatal intensive care unit (NICU) hospitalization and to compare this with term infants living in the community.

STUDY DESIGN

From March 2013 through March 2015, we enrolled 189 newborns (96 term and 93 preterm) into a prospective, longitudinal study obtaining nose/throat swabs within 7 days of birth, weekly while hospitalized and then monthly to 4 months after hospital discharge. Taqman array cards were used to identify 16 viral respiratory pathogens by real-time polymerase chain reaction. Demographic, clinical, and laboratory data were gathered from electronic medical records, and parent interview while hospitalized with interval histories collected at monthly visits. The hospital course of all preterm infants who underwent late-onset sepsis evaluations was reviewed.

RESULTS

Over 119 weeks, we collected 618 nose/throat swabs from at risk preterm infants in our level IV regional NICU. Only 4 infants had viral respiratory infections, all less than 28 weeks gestation at birth. Two infants were symptomatic with the infections recognized by the clinical team. The daily risk of acquiring a respiratory viral infection in preterm infants in the NICU was significantly lower than in the full term cohort living in the community. Once discharged from the hospital, viral respiratory infections were common in all infants.

CONCLUSIONS

Viral respiratory infections are infrequent in a NICU with strict infection prevention strategies and do not appear to cause unrecognized illness. Both preterm and term infants living in the community quickly acquire respiratory viral infections.

摘要

目的

确定新生儿重症监护病房(NICU)住院期间及之后早产儿病毒性呼吸道感染的负担,并将其与社区足月儿进行比较。

研究设计

2013年3月至2015年3月,我们招募了189名新生儿(96名足月儿和93名早产儿)进行一项前瞻性纵向研究,在出生后7天内采集鼻/咽拭子,住院期间每周采集一次,出院后每月采集一次,直至出院后4个月。使用Taqman阵列卡通过实时聚合酶链反应鉴定16种病毒性呼吸道病原体。从电子病历中收集人口统计学、临床和实验室数据,并在住院期间进行家长访谈,每月随访时收集间隔病史。回顾了所有接受晚发性败血症评估的早产儿的住院过程。

结果

在119周的时间里,我们从我们四级区域NICU的高危早产儿中收集了618份鼻/咽拭子。只有4名婴儿患有病毒性呼吸道感染,所有婴儿出生时孕周均小于28周。2名婴儿出现感染症状,临床团队识别出了这些感染。NICU中早产儿获得呼吸道病毒感染的每日风险显著低于社区中的足月儿队列。一旦出院,病毒性呼吸道感染在所有婴儿中都很常见。

结论

在采取严格感染预防策略的NICU中,病毒性呼吸道感染并不常见,似乎也不会导致未被识别的疾病。社区中的早产儿和足月儿都会很快感染呼吸道病毒。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f66/7094285/c7f0194239db/ympd8862-fig-0002_lrg.jpg

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