Pediatr Infect Dis J. 2018 Feb;37(2):113-118. doi: 10.1097/INF.0000000000001718.
Sepsis-like illness is a main cause for hospital admission in young infants. Our aim was to investigate incidence, epidemiology and clinical characteristics of enterovirus (EV) and human parechovirus (HPeV) infections in young infants with sepsis-like illness.
This is a prospective observational cohort study in which infants younger than 90 days of age, presenting with sepsis-like symptoms in a secondary care children's hospital, underwent a full sepsis work-up. Clinical signs and infectious indices were recorded. EV or HPeV RNA was detected by polymerase chain reaction in plasma and/or cerebrospinal fluid (CSF).
Infants were diagnosed with EV, HPeV, fever of unknown origin or severe infection. EV and HPeV were detected in 132 of 353 (37%) and 52 of 353 (15%) of cases, respectively. EV and HPeV have distinct seasonability. Some differences in clinical signs and symptoms occurred between children with EV and HPeV infection but were of limited clinical value. CSF pleocytosis occurred in 44% of EV positive infants, and only in 13% of those with HPeV infection.
EV and HPeV infections are major causes of sepsis-like illness in infants < 90 days of age. Neither clinical characteristics nor laboratory indices were predictive for EV/HPeV infection. CSF pleocytosis occurs, but not in all patients. Testing for EV and HPeV in all young infants with sepsis-like illness is strongly advised.
脓毒症样疾病是导致婴幼儿住院的主要原因。我们的目的是研究肠病毒（EV）和人副肠孤病毒（HPeV）感染在脓毒症样疾病婴幼儿中的发病率、流行病学和临床特征。
这是一项前瞻性观察性队列研究，研究对象为在二级保健儿童医院就诊的 90 天以下、出现脓毒症样症状的婴儿。对所有婴儿进行全面的脓毒症检查。记录临床症状和感染指标。通过聚合酶链反应在血浆和/或脑脊液（CSF）中检测 EV 或 HPeV RNA。
婴儿被诊断为 EV、HPeV、不明原因发热或严重感染。在 353 例病例中，分别有 132 例（37%）和 52 例（15%）检测到 EV 和 HPeV。EV 和 HPeV 具有明显的季节性。EV 和 HPeV 感染患儿的临床症状和体征存在一些差异，但临床价值有限。CSF 白细胞增多发生在 44%的 EV 阳性婴儿中，而在 HPeV 感染婴儿中仅发生在 13%。
EV 和 HPeV 感染是 90 天以下婴儿脓毒症样疾病的主要原因。临床特征和实验室指标均不能预测 EV/HPeV 感染。CSF 白细胞增多，但并非所有患者都有。强烈建议对所有脓毒症样疾病的婴幼儿进行 EV 和 HPeV 检测。
