新冠疫情期间坏死性小肠结肠炎发病率意外下降——一项单中心回顾性研究

Unexpected decrease in necrotizing enterocolitis morbidity during the COVID-19 pandemic-A single-centre retrospective study.

作者信息

Wang Yu, Cui Mingling, Li Lili, Gao Chuchu, Feng Zongtai, Cai Yan, Yang Zuming, Shen Lirong

机构信息

Department of Neonatology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China.

出版信息

Front Pediatr. 2024 May 28;12:1346478. doi: 10.3389/fped.2024.1346478. eCollection 2024.

DOI:10.3389/fped.2024.1346478

PMID:38863524

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11165084/

Abstract

BACKGROUND

The impact of the coronavirus disease 2019 (COVID-19) pandemic on neonatal necrotizing enterocolitis (NEC) is not well characterised. This cross-sectional study evaluated the potential effects of pandemic-related measures on NEC morbidity in premature infants in a neonatal ward during the COVID-19 pandemic.

METHODS

This was a retrospective study conducted in a tertiary neonatal ward in eastern and central China over 6 consecutive years (2017, 2018, 2019, 2020, 2021 and 2022). The medical records of 189 premature infants with stage II or III NEC were reviewed for clinical manifestations and aetiologies. The data were analysed and compared between the prepandemic period (2017, 2018, and 2019) and the pandemic period (2020, 2021 and 2022).

RESULTS

A total of 9,903 infants with gestational age (GA) < 37 weeks were enrolled, including 5,382 in the prepandemic period and 4,521 in the pandemic period. A reduction in stage II or III NEC morbidity was observed in infants with GA < 37 weeks, with an average annual morbidity of 2.29% (123/5,382) (95% CI, 1.89%-2.68%) in the prepandemic period and 1.46% (66/4,521) (95% CI, 1.11%-1.81%) in the pandemic period. NEC morbidity showed resurgent characteristics in 2021. When prepandemic coinfections were excluded, most cases of NEC with bloodstream infections in the prepandemic period were attributable to Gram-negative bacteria (27/32, 84.38%), mainly , while in the pandemic period they were attributable to Gram-positive bacteria (10/18, 55.56%), mainly . Antimicrobial susceptibility testing revealed that was 100% sensitive to meropenem, imipenem, ciprofloxacin and levofloxacin and 100% resistant to ampicillin. was 100% sensitive to vancomycin, linezolid, tetracycline, cotrimoxazole and cefoxitin and 100% resistant to penicillin and benzathine.

CONCLUSIONS

COVID-19 pandemic-related interventions can reduce the morbidity of NEC and change the pathogen spectrum in patients with bloodstream infections. We need to understand the exact factors leading to these changes.

摘要

背景

2019年冠状病毒病（COVID-19）大流行对新生儿坏死性小肠结肠炎（NEC）的影响尚不明确。本横断面研究评估了COVID-19大流行期间与大流行相关措施对新生儿病房早产儿NEC发病率的潜在影响。

方法

这是一项在中国东部和中部一家三级新生儿病房进行的回顾性研究，为期6年（2017年、2018年、2019年、2020年、2021年和2022年）。回顾了189例II期或III期NEC早产儿的病历，以了解临床表现和病因。对大流行前时期（2017年、2018年和2019年）和大流行时期（2020年、2021年和2022年）的数据进行分析和比较。

结果

共纳入9903例孕周（GA）<37周的婴儿，其中大流行前时期5382例，大流行时期4521例。观察到GA<37周的婴儿II期或III期NEC发病率有所降低，大流行前时期的年均发病率为2.29%（123/5382）（95%CI，1.89%-2.68%），大流行时期为1.46%（66/4521）（95%CI，1.11%-1.81%）。NEC发病率在2021年呈现反弹特征。排除大流行前的合并感染后，大流行前时期大多数伴有血流感染的NEC病例归因于革兰氏阴性菌（27/32，84.38%），主要是，而在大流行时期则归因于革兰氏阳性菌（10/18，55.56%），主要是。药敏试验显示对美罗培南、亚胺培南、环丙沙星和左氧氟沙星100%敏感，对氨苄西林100%耐药。对万古霉素、利奈唑胺、四环素、复方新诺明和头孢西丁100%敏感，对青霉素和苄星青霉素100%耐药。