Neonatal Medicine

  • 제16권2호
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  • Pages.182-189
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  • 2009
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  • 2287-9412(pISSN)
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  • 2287-9803(eISSN)
대한신생아학회 (The Korean Society of Neonatology)
권호 표지

신생아집중치료실에서의 급성 호흡기 감염-바이러스의 검출 및 respiratory syncytial virus 감염의 임상적 특징

Acute Respiratory Infections in the Neonatal Intensive Care Unit: Isolation of Viruses and the Characteristics of Respiratory Syncytial Virus Infection

  • 박선희 (가천의과학대학교 길병원 소아청소년과) ;
  • 조혜정 (가천의과학대학교 길병원 소아청소년과) ;
  • 심소연 (가천의과학대학교 길병원 소아청소년과) ;
  • 손동우 (가천의과학대학교 길병원 소아청소년과) ;
  • 은병욱 (가천의과학대학교 길병원 소아청소년과) ;
  • 선용한 (가천의과학대학교 길병원 소아청소년과) ;
  • 차한 (가천의과학대학교 길병원 소아청소년과) ;
  • 전인상 (가천의과학대학교 길병원 소아청소년과)
  • Park, Sun-Hee (Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science) ;
  • Cho, Hye-Jung (Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science) ;
  • Shim, So-Yeon (Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science) ;
  • Son, Dong-Woo (Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science) ;
  • Eun, Byung-Wook (Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science) ;
  • Sun, Yong-Han (Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science) ;
  • Tchah, Hann (Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science) ;
  • Jeon, In-Sang (Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science)
  • 발행 : 2009.11.30

⟨ 이전 논문 다음 논문 ⟩

초록

목 적 : 최근 multiplex RT-PCR의 개발로 급성 호흡기 감염에서 바이러스의 검출이 용이해졌다. 지금까지 respiratory syncytial virus (RSV)에 대한 연구는 많았지만 이전에 건강했던 신생아나 미숙아로 출생한 어린 영아에 대한 연구는 많지 않고 더욱이 이들에서의 다른 호흡기 바이러스에 대한 연구는 거의 없다. 저자들은 신생아집중치료실에 입원한 급성 호흡기 감염 환아를 대상으로 바이러스를 검출하고 다른 바이러스와 비교한 RSV 감염의 특성을 알아보고자 하였다. 방 법 : 신생아집중치료실에 급성 호흡기 감염으로 입원하여 multiplex RT-PCR을 시행한 환아를 대상으로 전향적 관찰 연구를 시행하였다. 모든 환아를 RSV군과 RSV가 검출되지 않은 No RSV 군으로 나누어 인구학적 특징과 임상양상 및 혈액검사와 흉부X-선 검사결과를 비교하였다. 결 과 : RSV 군은 23명(50%)이었다. Rhinovirus는 15.2%로 두 번째로 많이 검출되었다. RSV는 1월과 2월에, rhinovirus는 4월에 중점적으로 발생하였다. 중복감염 된 환아는 세 명(6.5%)이었다. 미숙아 수와 형제가 있거나 흡연에 노출 된 경우는 두 군간 차이가 없었으나 RSV 군에서 조리원 감염이 유의하게 많았다(60.9% vs. 21.7%, P=.007). RSV 군에서 No RSV 군에 비해 호흡곤란(34.8% vs. 8.7%, P=.032)과 폐렴(73.9% vs. 43.5%, P=.036)으로 입원한 환아가 많았고 산소 투여(52.5% vs. 13.0%, P=.005)와 금식(43.5% vs. 13.0%, P=.022)이 필요한 경우가 많았다. 우측상엽의 침윤도 RSV 군에서 많았다(56.5% vs. 8.7%, P=.001). 결 론 : 신생아나 미숙아로 출생했던 어린 영아는 RSV 뿐만 아니라 다른 다양한 호흡기 바이러스 감염으로 입원하게 된다. RSV 감염은 다른 감염에 비해 중증도가 높으므로 건강한 신생아에 대해서도 주의를 요하며 특히 조리원 등 밀집도가 높은 곳에서는 철저한 감염예방 관리가 필요하다.

Purpose: Recently, it is easy to find the causal virus of acute respiratory infections using multiplex RT-PCR. The aim of this study is to show the distribution of respiratory viruses and to define the characteristics of respiratory syncytial virus (RSV) infections compared to other respiratory viral infections. Methods: This was a prospective observational study conducted in the NICU. The infants with acute respiratory infections were performed multiplex RT-PCR using nasal swabs. The demographics, initial symptoms, course of illness, and laboratory and imaging findings were recorded. The infants were divided into RSV and No RSV groups. Results: Twenty-three infants (50%) were in the RSV group. Rhinovirus was the second most common virus. Coinfections with two viruses accounted for 6.5% of respiratory infections. The number of preterm infants, exposure to cigarette smoke and having siblings were not different between the two groups. Infections in the postnatal care center were more common in the RSV group than the No RSV group (60.9% vs. 21.7%, P=.007). Dyspnea (34.8% vs. 8.7%, P=.032) and pneumonia (73.9% vs. 43.5%, P=.036) were more common in the RSV group. The RSV group frequently needed oxygen (52.5% vs. 13.0%, P=.005) and received nothing by mouth (43.5% vs. 13.0%, P=.022). The incidence of right upper consolidation was higher in RSV group (56.5% vs. 8.7%, P=.001). Conclusion: This study showed that other viruses than RSV can induce respiratory infections in neonates and young infants born prematurely. RSV infections have a more severe course of illness than other respiratory viruses. We have to be careful of prevention even for healthy neonates especially in crowed situations, such as the postnatal care center.

키워드

참고문헌

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