신생아중환자실 내 로타바이러스 감염의 발생 및 임상 양상
Incidence and Clinical Manifestations of Rotaviral Infections in a Neonatal Intensive Care Unit
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose : This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods : Neonates diagnosed with rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results : Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion : Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.
Abstract
Purpose : This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods : Neonates diagnosed with rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results : Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion : Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.
참고문헌 (24)
- Graham DY, "Pathogenesis of rotavirus-induced diarrhea. Preliminary studies in miniature swine piglet", Dig Dis Sci, 29, pp.1028~1035 (1984)
- Sharma R, "Clinical manifestations of rotavirus infection in the neonatal intensive care unit", Pediatr Infect Dis J, 21, pp.1099~1105 (2002)
- Glass RI, "The epidemiology of rotavirus diarrhea in the United States: surveillance and estimates of disease burden", J Infect Dis, 174, pp.S5~S11 (1996)
- Parashar UD, "Hospitalizations associated with rotavirus diarrhea in the United States, 1993 through 1995: surveillance based on the new ICD-9-CM rotavirus-specific diagnostic code", J Infect Dis, 177, pp.13~17 (1998)
- Langley JM, "The role of Clostridium difficile and viruses as causes of nosocomial diarrhea in children", Infect Control Hosp Epidemiol, 23, pp.660~664 (2002)
- Ratner AJ, "Nosocomial rotavirus in a pediatric hospital", Infect Control Hosp Epidemiol, 22, pp.299~301 (2001)
- 박민경, "신생아와 영유아 로타바이러스 위장염의 임상 경과에 대한 비교", 대한소아소화기영양학회지, 9(2), pp.153~161 (2006), 대한소아소화기영양학회
- Lee JH, "Comparison among diagnostic methods of rotaviral gastroenteritis in children", Korean J Pediatr Gastroenterol Nutr, 4, pp.34~40 (2001)
- Chung KO, "Study of nosocomial infection of rotavirus in preterm and full-term neonates", J Korean Pediatr Soc, 42, pp.332~338 (1999)
- 이소영, "수유 및 분만방법에 따른 신생아실 로타바이러스 원내감염의 증상 차이", Korean Journal of Pediatrics, 46(5), pp.454~458 (2003), 대한소아과학회
- 박지영, "서울시내 1개 산후 조리원에서 시행한 로타바이러스 선별검사에 대한 분석", 소아감염, 14(2), pp.145~154 (2007), 한국소아감염병학회
- Verboon-Maciolek MA, "Clinical and epidemiologic characteristics of viral infections in a neonatal intensive care unit during a 12-year period", Pediatr Infect Dis J, 24, pp.901~904 (2005)
- Murphy AM, "Rotavirus infections of neonates", Lancet, 2, pp.1149~1150 (1977)
- Chrystie IL, "Asymptomatic endemic rotavirus infections in the newborn", Lancet, 1, pp.1176~1178 (1978)
- Bishop RF, "Clinical immunity after neonatal rotavirus infection. A prospective longitudinal study in young children", N Engl J Med, 309, pp.72~76 (1983)
- Rotbart HA, "Neonatal rotavirus- associated necrotizing enterocolitis: case control study and prospective surveillance during an outbreak", J Pediatr, 112, pp.87~93 (1988)
- Rotbart HA, "An outbreak of rotavirus-associated neonatal necrotizing enterocolitis", J Pediatr, 103, pp.454~459 (1983)
- 서현주, "로타바이러스 감염이 관련된 신생아 괴사성 장염", Korean Journal of Pediatrics, 52(1), pp.56~60 (2009), 대한소아과학회
- DiFazio MP, "Rotavirus-induced seizures in childhood", J Child Neurol, 22, pp.1367~1370 (2007)
- Widdowson MA, "An outbreak of diarrhea in a neonatal medium care unit caused by a novel strain of rotavirus: investigation using both epidemiologic and microbiological methods", Infect Control Hosp Epidemiol, 23, pp.665~670 (2002)
- 장지민, "신생아실 로타바이러스 유행의 역학적 특성과 효과적인 조절 대책에 관한 연구", Infection and Chemotherapy, 37(6), pp.311~318 (2005), 대한감염학회
- Lee HJ, "Rotavirus infection in the nursery", Korean J Perinatol, 14, pp.36~41 (2003)
- Mastretta E, "Effect of Lactobacillus GG and breast-feeding in the prevention of rotavirus nosocomial infection", J Pediatr Gastroenterol Nutr, 35, pp.527~531 (2002)
- Sharma R, "Rotavirus-associated necrotizing enterocolitis: an insight into a potentially preventable disease?", J Pediatr Surg, 39, pp.453~457 (2004)