From the University of New South Wales.
School of Women's and Children's Health, University of New South Wales, Kensington.
Pediatr Infect Dis J. 2022 Jul 1;41(7):579-586. doi: 10.1097/INF.0000000000003531. Epub 2022 Jun 7.
To determine the characteristics and outcomes of postnatal cytomegalovirus (pCMV) infection in preterm infants in a neonatal intensive care unit (NICU).
A retrospective, matched case-control study in a tertiary NICU. Infants born between January 2009 and December 2019, <32 weeks' gestational age (GA) and/or birth weight (BW) <1500 g with pCMV infection were matched 1:1 with cytomegalovirus-(CMV)-negative infants by year of admission, gender, GA and BW. Primary outcome was death ≤36 weeks' postmenstrual age or bronchopulmonary dysplasia (BPD). Secondary outcomes were length of ventilation (LOV), length of stay (LOS) and neurodevelopmental impairment (NDI) at corrected age 1 and 2 years.
Forty-eight pCMV-positive infants (median GA 25.3 weeks, BW 695 g, age 58 days) were identified from 1659 infants (incidence 2.9%). The most common symptoms of pCMV infection were abdominal distension (43.8%), sepsis-like syndrome (29.2%), thrombocytopenia (60.5%) and conjugated hyperbilirubinemia (60.9%). Compared with controls, there were no significant differences in the composite outcome of death or BPD (56.3% vs. 37.5%; P = 0.1) or NDI at 1 and 2 years (51.9% vs. 44%; P = 0.8; 71.4% vs. 50%; P = 0.4). pCMV-positive infants had a significantly longer median LOV (23.5 vs. 12 days)* and LOS (140 vs. 110.5 days)*. Eleven (22.9%) infants received antivirals. Ten improved and 1 died. Two untreated infants died (1 from pCMV infection).
Clinically identifiable pCMV infections are significant and associated with increased respiratory support and prolonged hospital stay in vulnerable infants. pCMV screening and preventive measures against transmission merit consideration.*P < 0.05.
为了确定新生儿重症监护病房（NICU）中早产儿出生后巨细胞病毒（pCMV）感染的特征和结局。
这是一项在三级 NICU 进行的回顾性、匹配病例对照研究。2009 年 1 月至 2019 年 12 月期间，出生胎龄（GA）<32 周且/或出生体重（BW）<1500g 并伴有 pCMV 感染的婴儿，按照入院年份、性别、GA 和 BW 与巨细胞病毒（CMV）阴性婴儿进行 1:1 匹配。主要结局为≤36 周校正胎龄（CA）死亡或支气管肺发育不良（BPD）。次要结局为校正 CA1 和 CA2 时的通气时间（LOV）、住院时间（LOS）和神经发育损伤（NDI）。
从 1659 名婴儿中（发生率为 2.9%）确定了 48 名 pCMV 阳性婴儿（中位 GA 为 25.3 周，BW 为 695g，年龄为 58 天）。pCMV 感染最常见的症状为腹胀（43.8%）、类似败血症的综合征（29.2%）、血小板减少（60.5%）和结合性高胆红素血症（60.9%）。与对照组相比，死亡或 BPD 的复合结局（56.3% vs. 37.5%；P=0.1）或 CA1 和 CA2 时的 NDI（51.9% vs. 44%；P=0.8；71.4% vs. 50%；P=0.4）无显著差异。pCMV 阳性婴儿 LOV（23.5 天 vs. 12 天）*和 LOS（140 天 vs. 110.5 天）*显著延长。11 名（22.9%）婴儿接受了抗病毒治疗。10 名患儿好转，1 名患儿死亡。2 名未治疗的患儿死亡（1 例死于 pCMV 感染）。
临床上可识别的 pCMV 感染是显著的，并与脆弱婴儿的呼吸支持增加和住院时间延长有关。pCMV 筛查和预防传播的措施值得考虑。*P<0.05。
