Neonatal enterovirus infections reported to the national enterovirus surveillance system in the United States, 1983-2003
Neonatal enterovirus infections reported to the national enterovirus surveillance system in the United States, 1983-2003
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DOI：
10.1097/01.inf.0000237798.07462.32
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发表时间：
2006-10-01
影响因子：
3.6
通讯作者：
Pallansch, Mark
中科院分区：
文献类型：
--
作者：
Khetsuriani, Nino;LaMonte, Ashley;Pallansch, Mark
背景资料：新生儿肠道病毒（EV）感染可导致多种临床表现，从轻度发热性疾病到严重的败血症样疾病，有时甚至是致命的。方法：分析1983- 2003年国家肠道病毒监测系统（NESS）报告的数据，以确定EV血清型与新生儿感染风险及其致命结局的关系。在此期间报告的26，737例EV检测中，新生儿占2544例（占已知年龄的11.4%）。从新生儿分离的最常见血清型包括埃可病毒（E）11（已知血清型EV的14.0%）、柯萨奇病毒（CV）B2（8.9%）、CVB 5（7.5%）、E6、E9和CVB 4（各6.8%）。CVB 1-4、E11和E25在新生儿中明显更常见，而CVA 16、E4、E9、E21、E30和人双埃柯病毒1型（以前的E22）在新生儿中比在≥ 1个月的人群中更不常见。有3.3%的报告出现了致死性结局，新生儿的死亡风险高于年龄≥ 1个月的人群（11.5% vs 2.5%;比值比[OR] 5.1; 95%置信区间[CI] = 3.3-7.8）。CVB 4感染新生儿的死亡风险高于其他EV感染者（OR 6.5，95%CI = 2.4-17.7）。结论：EV是新生儿感染和死亡的重要病原体。由于NESS的局限性（报告不完整，临床数据有限，偏向更严重和更年轻的病例），需要进行更多的研究以更好地评估不同EV在新生儿感染中的作用。
Background: Neonatal enterovirus (EV) infections lead to a wide range of clinical manifestations, from mild febrile illness to severe, sometimes fatal, sepsislike disease.Methods: To determine the relationship of EV serotypes with the risk of neonatal infection and its fatal outcome, we analyzed data reported to the National Enterovirus Surveillance System (NESS) during 1983-2003.Results: Of the 26,737 EV detections reported during this period, neonates accounted for 2544 (11.4% of those with known age). Serotypes most commonly isolated from neonates included echovirus (E) 11 (14.0% of EV with known serotype), coxsackievirus (CV) B2 (8.9%), CVB5 (7.5%), E6, E9 and CVB4 (6.8% each). CVB 1-4, E11, and E25 were significantly more common, whereas CVA16, E4, E9, E21, E30, and human parechovirus 1 (formerly E22) were less common among neonates than among persons aged >= 1 month. Fatal outcome was noted for 3.3% of reports, with neonates at a higher risk of death than persons aged >= 1 month (11.5% versus 2.5%; odds ratio [OR] 5.1; 95% confidence interval [CI] = 3.3-7.8). Neonates infected with CVB4 were at a higher risk of death (OR 6.5; 95% CI = 2.4-17.7) than those infected with other EV.Conclusion: EV are important neonatal pathogens associated with high risk of infection and death. Because of the limitations of the NESS (incomplete reporting, limited clinical data, bias towards more severe and younger cases), additional studies are needed to better evaluate the role of different EV in neonatal infections.