Department of Neonatology, Children's Hospital of Soochow University, Suzhou, China.
Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China.
BMC Pediatr. 2022 Jul 27;22(1):452. doi: 10.1186/s12887-022-03508-7.
Pneumonia is a serious problem that threatens the health of newborns. This study aimed to investigate the clinical characteristics of hospitalized term and preterm infants with community-acquired viral pneumonia.
This was a retrospective analysis of cases of community-acquired viral pneumonia in the Neonatal Department. Nasopharyngeal aspirate (NPA) samples were collected for pathogen detection, and clinical data were collected. We analysed pathogenic species and clinical characteristics among these infants.
RSV is the main virus in term infants, and parainfluenza virus (PIV) 3 is the main virus in preterm infants. Patients infected with PIV3 were more susceptible to coinfection with bacteria than those with respiratory syncytial virus (RSV) infection (p < 0.05). Preterm infants infected with PIV3 were more likely to be coinfected with bacteria than term infants (p < 0.05), mainly gram-negative bacteria (especially Klebsiella pneumonia). Term infants with bacterial infection were more prone to fever, cyanosis, moist rales, three concave signs, elevated C-reactive protein (CRP) levels, respiratory failure and the need for higher level of oxygen support and mechanical ventilation than those with simple viral infection (p < 0.05). The incidence of hyponatremia in neonatal community-acquired pneumonia (CAP) was high.
RSV and PIV3 were the leading causes of neonatal viral CAP. PIV3 infection is the main cause of viral CAP in preterm infants, and these individuals are more likely to be coinfected with bacteria than term infants, mainly gram-negative bacteria. Term infants with CAP coinfected with bacteria were more likely to have greater disease severity than those with single viral infections.
肺炎是一种严重威胁新生儿健康的疾病。本研究旨在探讨社区获得性病毒性肺炎住院足月和早产儿的临床特征。
这是一项对新生儿科社区获得性病毒性肺炎病例的回顾性分析。采集鼻咽抽吸物（NPA）样本进行病原体检测，并收集临床资料。我们分析了这些婴儿的病原种类和临床特征。
RSV 是足月儿的主要病毒，而副流感病毒（PIV）3 是早产儿的主要病毒。与 RSV 感染相比，感染 PIV3 的患者更易合并细菌感染（p<0.05）。与 RSV 感染相比，感染 PIV3 的早产儿更易合并细菌感染（p<0.05），主要为革兰氏阴性菌（尤其是肺炎克雷伯菌）。合并细菌感染的足月儿比单纯病毒感染的足月儿更容易出现发热、发绀、湿啰音、三凹征、C 反应蛋白（CRP）水平升高、呼吸衰竭和需要更高水平的氧支持和机械通气（p<0.05）。新生儿社区获得性肺炎（CAP）低钠血症的发生率较高。
RSV 和 PIV3 是引起新生儿病毒性 CAP 的主要原因。PIV3 感染是早产儿病毒性 CAP 的主要原因，与足月儿相比，这些患者更易合并细菌感染，主要为革兰氏阴性菌。合并细菌感染的 CAP 足月儿比单纯病毒感染的足月儿病情更严重。
