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有症状的先天性和出生后巨细胞病毒感染婴儿的临床特征——台湾一项为期11年的多中心队列研究

Clinical Characteristics of Infants with Symptomatic Congenital and Postnatal Cytomegalovirus Infection-An 11-Year Multicenter Cohort Study in Taiwan.

作者信息

Chen Yu-Ning, Hsu Kai-Hsiang, Huang Chung-Guei, Chiang Ming-Chou, Chu Shih-Ming, Chen Chyi-Liang, Hsu Jen-Fu, Chueh Ho-Yen

机构信息

Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan.

College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.

出版信息

Children (Basel). 2023 Dec 22;11(1):17. doi: 10.3390/children11010017.

Abstract

(1) Background: Cytomegalovirus (CMV) infection is a prevalent viral disease among infants. The prevalence typically ranges from 0.2% to 2.4% among all newborns. There are limited data regarding the demographic characteristics of infants with symptomatic CMV infections. (2) Methods: In this retrospective cohort study using the Chang Gung Memorial Hospital multicenter database, infants with CMV infection determined by a positive urine culture, positive blood polymerase chain reaction assay or positive immunoglobulin M result for CMV from 2011 through 2021 were included. Clinical characteristics at initial diagnosis, management and outcomes were investigated. Congenital CMV (cCMV) infection is diagnosed within three weeks after birth; postnatal CMV (pCMV) is diagnosed when CMV is detected after the first 3 weeks of life. (3) Results: Among the 505 CMV-infected infants identified, 272 were included in the analysis. According to the age at initial presentation, 21 infants had cCMV infection and 251 had pCMV infection. Higher incidences of prematurity and being small for gestational age and a lower Z score for weight at diagnosis were observed in the cCMV group. While thrombocytopenia (61.9%) was the leading presentation in the cCMV group, hepatitis (59.8%) and prolonged jaundice (21.9%) were more common in the pCMV group. (4) Conclusions: Utilizing an 11-year multicenter database, we demonstrated the characteristics of infants with CMV infection in Taiwan and highlighted the demographic disparities and differing symptoms between the cCMV and pCMV groups. These findings emphasize the necessity for future research to refine screening policies, explore treatment options, and establish follow-up protocols for affected infants.

摘要

(1)背景:巨细胞病毒(CMV)感染是婴儿中一种常见的病毒性疾病。在所有新生儿中,其患病率通常在0.2%至2.4%之间。关于有症状CMV感染婴儿的人口统计学特征的数据有限。(2)方法:在这项使用长庚纪念医院多中心数据库的回顾性队列研究中,纳入了2011年至2021年期间通过尿培养阳性、血液聚合酶链反应检测阳性或CMV免疫球蛋白M结果阳性确诊为CMV感染的婴儿。研究了初始诊断时的临床特征、管理情况及结局。先天性CMV(cCMV)感染在出生后三周内确诊;出生后CMV(pCMV)感染在出生后3周后检测到CMV时确诊。(3)结果:在确定的505例CMV感染婴儿中,272例纳入分析。根据初次就诊时的年龄,21例婴儿患有cCMV感染,251例患有pCMV感染。cCMV组中早产和小于胎龄儿的发生率较高,诊断时体重的Z评分较低。虽然血小板减少症(61.9%)是cCMV组的主要表现,但肝炎(59.8%)和黄疸持续时间延长(21.9%)在pCMV组中更为常见。(4)结论:利用一个11年的多中心数据库,我们展示了台湾CMV感染婴儿的特征,并强调了cCMV组和pCMV组之间的人口统计学差异和不同症状。这些发现强调了未来研究完善筛查政策、探索治疗选择以及为受影响婴儿建立随访方案的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/912c/10813870/d26df1aa13b7/children-11-00017-g001.jpg

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