新型冠状病毒感染期间足月的晚期新生儿咽拭子肠道病毒核酸检测横断面研究

史明睿; 徐海冬; 王红; 黑明燕

doi:10.7499/j.issn.1008-8830.2212023

PDF(569 KB)

HTML

中国当代儿科杂志 ›› 2023, Vol. 25 ›› Issue (4) : 339-343. DOI: 10.7499/j.issn.1008-8830.2212023

疫情专栏

新型冠状病毒感染期间足月的晚期新生儿咽拭子肠道病毒核酸检测横断面研究

史明睿, 徐海冬, 王红, 黑明燕

作者信息 +

A cross-sectional study of enterovirus nucleic acid test with throat swabs for term late neonates during coronavirus disease 2019

SHI Ming-Rui, XU Hai-Dong, WANG Hong, HEI Ming-Yan

Author information +

文章历史 +

摘要

目的探讨新型冠状病毒感染疫情期间住院的足月的晚期新生儿咽拭子肠道病毒（enterovirus，EV）核酸检测阳性率及其临床特征。方法该研究为单中心横断面研究，研究对象为2020年10月—2021年9月在新生儿内科病房住院的611例足月的晚期新生儿。于入院时采集咽拭子进行柯萨奇病毒A16型/EV71/EV通用型核酸检测。根据EV核酸检测结果分为EV核酸阳性组（8例）和EV核酸阴性组（603例），分析比较两组患儿的临床特征差异。结果 611例患儿中，8例EV核酸检测阳性，阳性率为13.1‰，其中7例在5—10月份入院。EV核酸阳性组与EV核酸阴性组患儿起病前与有呼吸道感染症状的家庭成员接触比例分别为75.0%和10.9%（P<0.001）。两组患儿在人口学信息、临床症状、实验室检验方面差异无统计学意义（P>0.05）。结论新型冠状病毒感染疫情期间住院的足月的晚期新生儿仍有一定比例的咽拭子EV核酸检测呈阳性但比例较低，其临床表现和实验室常规检测结果无特异性；家庭成员之间的传播可能是新生儿感染EV的重要途径。中国当代儿科杂志，2023，25（4）：339-343］

Abstract

Objective To investigate the positive rate of enterovirus (EV) nucleic acid in throat swabs of term late neonates hospitalized during the coronavirus disease 2019 (COVID-19) epidemic and the clinical characteristics of the neonates. Methods A single-center cross-sectional study was performed on 611 term late infants who were hospitalized in the neonatal center from October 2020 to September 2021. Throat swabs were collected on admission for coxsackie A16 virus/EV71/EV universal nucleic acid testing. According to the results of EV nucleic acid test, the infants were divided into a positive EV nucleic acid group (8 infants) and a negative EV nucleic acid group (603 infants). Clinical features were compared between the two groups. Results Among the 611 neonates, 8 tested positive for EV nucleic acid, with a positive rate of 13.1‰, among whom 7 were admitted from May to October. There was a significant difference in the proportion of infants contacting family members with respiratory infection symptoms before disease onset between the positive and negative EV nucleic acid groups (75.0% vs 10.9%, P<0.001). There were no significant differences between the two groups in demographic data, clinical symptoms, and laboratory test results (P>0.05). Conclusions There is a certain proportion of term late infants testing positive for EV nucleic acid in throat swabs during the COVID-19 epidemic, but the proportion is low. The clinical manifestations and laboratory test results of these infants are non-specific. Transmission among family members might be an important cause of neonatal EV infection. Citation:Chinese Journal of Contemporary Pediatrics, 2023, 25(4): 339-343

导出引用

史明睿, 徐海冬, 王红, 黑明燕. 新型冠状病毒感染期间足月的晚期新生儿咽拭子肠道病毒核酸检测横断面研究[J]. 中国当代儿科杂志. 2023, 25(4): 339-343 https://doi.org/10.7499/j.issn.1008-8830.2212023

SHI Ming-Rui, XU Hai-Dong, WANG Hong, HEI Ming-Yan. A cross-sectional study of enterovirus nucleic acid test with throat swabs for term late neonates during coronavirus disease 2019[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(4): 339-343 https://doi.org/10.7499/j.issn.1008-8830.2212023

参考文献

1 陆佩, 张澜, 程国强, 等. 新生儿肠道病毒感染81例回顾分析及不良结局评分系统的建立[J]. 中华新生儿科杂志, 2019, 34(3): 177-181. DOI: 10.3760/cma.j.issn.2096-2932.2019.03.004.
2 Olchawa-Czech A, Ptak K, Szymońska I, et al. Severe enterovirus infections in infants <3 months of age and the importance of medical history[J]. J Mother Child, 2021, 24(3): 37-44. PMID: 33548163. PMCID: PMC8258841. DOI: 10.34763/jmotherandchild.20202403.2022.d-20-00007.
3 史明睿, 黑明燕. 新生儿肠道病毒核酸序列检测应用进展[J]. 中华新生儿科杂志, 2021, 36(3): 63-66. DOI: 10.3760/cma.j.issn.2096-2932.2021.03.017.
4 王宏宇, 张小爱, 许红梅, 等. 手足口病患者不同标本中肠道病毒检测结果比较[J]. 中华疾病控制杂志, 2014, 18(6): 501-503.
5 Noor A, Krilov LR. Enterovirus infections[J]. Pediatr Rev, 2016, 37(12): 505-515. PMID: 27909105. DOI: 10.1542/pir.2016-0103.
6 Cordey S, Schibler M, L'Huillier AG, et al. Comparative analysis of viral shedding in pediatric and adult subjects with central nervous system-associated enterovirus infections from 2013 to 2015 in Switzerland[J]. J Clin Virol, 2017, 89: 22-29. PMID: 28214758. DOI: 10.1016/j.jcv.2017.01.008.
7 Khetsuriani N, Lamonte A, Oberste MS, et al. Neonatal enterovirus infections reported to the national enterovirus surveillance system in the United States, 1983-2003[J]. Pediatr Infect Dis J, 2006, 25(10): 889-893. PMID: 17006282. DOI: 10.1097/01.inf.0000237798.07462.32.
8 Cabrerizo M, Díaz-Cerio M, Mu?oz-Almagro C, et al. Molecular epidemiology of enterovirus and parechovirus infections according to patient age over a 4-year period in Spain[J]. J Med Virol, 2017, 89(3): 435-442. PMID: 27505281. DOI: 10.1002/jmv.24658.
9 Li W, Zhang X, Chen X, et al. Epidemiology of childhood enterovirus infections in Hangzhou, China[J]. Virol J, 2015, 12: 58. PMID: 25884568. PMCID: PMC4403759. DOI: 10.1186/s12985-015-0294-4.
10 Lv XQ, Qian LH, Wu T, et al. Enterovirus infection in febrile neonates: a hospital-based prospective cohort study[J]. J Paediatr Child Health, 2016, 52(8): 837-841. PMID: 27149142. DOI: 10.1111/jpc.13193.
11 Lafolie J, Labbé A, L'Honneur AS, et al. Assessment of blood enterovirus PCR testing in paediatric populations with fever without source, sepsis-like disease, or suspected meningitis: a prospective, multicentre, observational cohort study[J]. Lancet Infect Dis, 2018, 18(12): 1385-1396. PMID: 30389482. PMCID: PMC7164799. DOI: 10.1016/S1473-3099(18)30479-1.
12 Cortese F, Scicchitano P, Gesualdo M, et al. Early and late infections in newborns: where do we stand? A review[J]. Pediatr Neonatol, 2016, 57(4): 265-273. PMID: 26750406. DOI: 10.1016/j.pedneo.2015.09.007.
13 Belov Y, Many A, Givon I, et al. Maternal presentation and neonatal outcome in peripartum enterovirus infection[J]. Acta Paediatr, 2021, 110(5): 1483-1489. PMID: 33251624. DOI: 10.1111/apa.15703.
14 吴运芹, 高喜容, 詹敏, 等. 新生儿肠道病毒感染86例临床分析[J]. 中国小儿急救医学, 2020, 27(12): 925-928. DOI: 10.3760/cma.j.issn.1673-4912.2020.12.010.
15 马晓路, 杜立中. 新生儿暴发性肠道病毒感染的现状和防控策略[J]. 中华实用儿科临床杂志, 2020, 35(11): 817-819. DOI: 10.3760/cma.j.cn101070-20200224-00234.
16 Rittichier KR, Bryan PA, Bassett KE, et al. Diagnosis and outcomes of enterovirus infections in young infants[J]. Pediatr Infect Dis J, 2005, 24(6): 546-550. PMID: 15933567. DOI: 10.1097/01.inf.0000164810.60080.ad.
17 沈晓霞, 陈鸣艳, 陈军津, 等. 新生儿肠道病毒感染的临床特征分析[J]. 中国当代儿科杂志, 2020, 22(6): 638-642. PMID: 32571465. PMCID: PMC7390221. DOI: 10.7499/j.issn.1008-8830.1912038.
18 Xu S, Li H, Qiao P, et al. Neonatal hand, foot, and mouth disease due to coxsackievirus A6 in Shanghai[J]. BMC Pediatr, 2020, 20(1): 364. PMID: 32741368. PMCID: PMC7397588. DOI: 10.1186/s12887-020-02262-y.
19 Izumita R, Deuchi K, Aizawa Y, et al. Intrafamilial transmission of parechovirus a and enteroviruses in neonates and young infants[J]. J Pediatric Infect Dis Soc, 2019, 8(6): 501-506. PMID: 30184210. DOI: 10.1093/jpids/piy079.
20 Chang LY, Tsao KC, Hsia SH, et al. Transmission and clinical features of enterovirus 71 infections in household contacts in Taiwan[J]. JAMA, 2004, 291(2): 222-227. PMID: 14722149. DOI: 10.1001/jama.291.2.222.
21 Haston JC, Dixon TC. Nonpolio enterovirus infections in neonates[J]. Pediatr Ann, 2015, 44(5): e103-e107. PMID: 25996196. DOI: 10.3928/00904481-20150512-09.
22 许平, 申青华, 杨春燕, 等. 新生儿暴发性心肌炎11例临床特点分析[J]. 中华新生儿科杂志, 2018, 33(3): 196-199. DOI: 10.3760/cma.j.issn.2096-2932.2018.03.010.
23 覃菲, 黑明燕. 新生儿ECHO病毒11型感染诊治研究进展[J]. 中华医院感染学杂志, 2020, 30(18): 2739-2743. DOI: 10.11816/cn.ni.2020-201656.
24 Abzug MJ, Michaels MG, Wald E, et al. A randomized, double-blind, placebo-controlled trial of pleconaril for the treatment of neonates with enterovirus sepsis[J]. J Pediatric Infect Dis Soc, 2016, 5(1): 53-62. PMID: 26407253. PMCID: PMC4765488. DOI: 10.1093/jpids/piv015.
25 Torres-Torres S, Myers AL, Klatte JM, et al. First use of investigational antiviral drug pocapavir (v-073) for treating neonatal enteroviral sepsis[J]. Pediatr Infect Dis J, 2015, 34(1): 52-54. PMID: 25229269. DOI: 10.1097/INF.0000000000000497.
26 Raouf M, El-Din OS, Khadr NA, et al. Clinical and laboratory detection of nonpolio enteroviruses among different age groups of aseptic meningitis patients in Alexandria, Egypt[J]. J Med Virol, 2021, 93(6): 3389-3396. PMID: 32880992. DOI: 10.1002/jmv.26480.