新生儿社区与医院内呼吸道合胞病毒肺炎的临床特点  

Clinical characteristics of respiratory syncytial virus pneumonia among neonates with community-acquired and hospital-acquired infections

作　　者：张澜[1] 曹云[1] 钱甜[1] 陈超[1] 徐锦[1] 蔡小狄[1] 王瑾[1] 

机构地区：[1]复旦大学儿科医院新生儿科,上海201100

出　　处：《临床儿科杂志》2008年第12期1052-1055,共4页Journal of Clinical Pediatrics

摘　　要：目的了解新生儿社区与医院内呼吸道合胞病毒(RSV)肺炎的临床特点,以指导临床对新生儿RSV感染尤其是院内RSV感染肺炎进行有效防治。方法2005年11月-2006年4月新生儿科共收治RSV肺炎65例,所有患儿均有下呼吸道感染的临床表现,经X线、下呼吸道分泌物病毒检测确诊,其中社区感染56例,院内感染9例,分析两组的临床特点,并将9例院内感染患儿与国外2005年报道的9例院内暴发感染RSV的新生儿临床特点等进行比较。结果院内感染RSV患儿平均出生体重(中位数2625.0g)低于社区感染者(3342.5g),临床表现较严重,需进行重症监护治疗者较社区感染者多(P<0.05)。院内感染RSV患儿均存在基础疾病,同时合并细菌感染8例。9例院内感染RSV肺炎患儿与国外报道的院内感染暴发的患儿比较,平均胎龄(35+5周、30+3周)及出生体重(2625.0g、1757.0g)较大(P<0.05);需要吸氧的人数、机械通气人数两组差异均无统计学意义(P均>0.05),疾病严重程度相仿。结论新生儿院内RSV感染与社区感染相比病情更为严重。新生儿RSV感染常合并细菌感染。要重视RSV院内感染的防治。Objectives To study the clinical characteristics of respiratory syncytial virus （RSV） pneumonia among neonates with community-acquired and hospital-acquired infections, to further develop strategy for preventing RSV infection, especially hospital-acquired infections. Methods Total 65 neonates with RSV pneumonia, admitted to the neonatal unit of Children＇ s Hospital of Fudan University from November 2005 to April 2006 were enrolled in the study. Among them, 56 were community-acquired, and 9 were hospital-acquired infections. All patients were diagnosed by clinical manifestations, radiology examination and evidence of RSV in secretions from the lower respiratory tract. Clinical characteristics of both groups of patients were analyzed. Comparison was done between the 9 hospital-infected newborns and the 9 newborns in a NICU RSV outbreak reported in 2005. Results The mean birth weight of the infants with hospitalacquired infections （mean 2625.0 g） was lower than that of the infants with community-acquired infections（mean 3342.5 g）. There were more admissions to the intensive care among infants with hospital-acquired than those with community-acquired infections （P 〈 0.05）. All infants with hospital-acquired infections had underlying disease, and 8 of them had concurrent bacterial infections. Compared with the 9 cases of RSV outbreak reported elsewhere, the 9 hospital-infected neonates in this study had higher gestational age and mean birth weight （P 〈 0.05） . However, there was no significant difference regarding oxygen therapy and ventilator support requirement between two groups （P 〉 0.05） . The severity of the disease between two groups was similar. Conclusions Clinical manifestations of hospital-acquired RSV infections were more severe than the community-acquired infections in neonates. Neonates with RSV infection were prone to have concurrent bacterial infections. Severity of RSV infection was similar in hospital-acquired infected infants between this study and the outbreak previo

关 键 词：新生儿 呼吸道合胞病毒 医院内感染 社区感染 

分 类 号：R722.1[医药卫生—儿科]