Jonathan Davis1, Derek Fairley, Sharon Christie, Peter Coyle, Richard Tubman, Michael D Shields. 1. From the *Regional Neonatal Unit, St. Michael's Hospital, University Hospitals Bristol Foundation Trust, Bristol; †Microbiology, Belfast Health and Social Services Trust; ‡Royal Jubilee Maternity Hospital; §Royal Belfast Hospital for Sick Children, Belfast Health and Social Services Trust; and ¶Centre for Infection and Immunity, Queens University of Belfast, Belfast, United Kingdom.
Abstract
BACKGROUND: Approximately 5-6% of all infective episodes in neonatal intensive care unit (NICU) are of viral origin. Previous studies suggest that human parechovirus (HPeV) infection presents most commonly in term infants, as a sepsis-like syndrome in which meningoencephalitis is prominent. Our aim was to study the infection rate and associated features of HPeV. METHODS: Blood samples were taken from NICU babies older than 48 hours, who were being investigated for late onset sepsis. Clinical and laboratory data were collected at the time of the suspected sepsis episode. Samples were tested using universal primers and probe directed at the 5'-untranslated region of the HPeV genome by reverse transcriptase polymerase chain reaction (RT-PCR). Results were confirmed by electrophoresis and DNA sequencing. RESULTS: HPeV was detected in 11 of 84 samples (13%). These infants had a mean [interquartile range (IQR)] gestational age of 28.9 (26.9-30.6) weeks and mean birth weight of 1.26 (SD = 0.72) kg. The median day of presentation was 16 (IQR: 11-27). These characteristics were similar to the infants without positive viral detection. Six infants presented with respiratory signs. One infant presented with signs of meningitis. Six of the 11 episodes of HPeV infection occurred during the winter months (December to February). No HPeV positive infants had abnormal findings on their 28-day cranial ultrasound examination. CONCLUSIONS: We found an HPeV infection rate of 13% in infants being tested for late onset sepsis. HPeV should be considered as a possible cause of sepsis-like symptoms in preterm infants.
BACKGROUND: Approximately 5-6% of all infective episodes in neonatal intensive care unit (NICU) are of viral origin. Previous studies suggest that human parechovirus (HPeV) infection presents most commonly in term infants, as a sepsis-like syndrome in which meningoencephalitis is prominent. Our aim was to study the infection rate and associated features of HPeV. METHODS: Blood samples were taken from NICU babies older than 48 hours, who were being investigated for late onset sepsis. Clinical and laboratory data were collected at the time of the suspected sepsis episode. Samples were tested using universal primers and probe directed at the 5'-untranslated region of the HPeV genome by reverse transcriptase polymerase chain reaction (RT-PCR). Results were confirmed by electrophoresis and DNA sequencing. RESULTS:HPeV was detected in 11 of 84 samples (13%). These infants had a mean [interquartile range (IQR)] gestational age of 28.9 (26.9-30.6) weeks and mean birth weight of 1.26 (SD = 0.72) kg. The median day of presentation was 16 (IQR: 11-27). These characteristics were similar to the infants without positive viral detection. Six infants presented with respiratory signs. One infant presented with signs of meningitis. Six of the 11 episodes of HPeV infection occurred during the winter months (December to February). No HPeV positive infants had abnormal findings on their 28-day cranial ultrasound examination. CONCLUSIONS: We found an HPeV infection rate of 13% in infants being tested for late onset sepsis. HPeV should be considered as a possible cause of sepsis-like symptoms in preterm infants.
Authors: Claire M Midgley; Mary Anne Jackson; Rangaraj Selvarangan; Patrick Franklin; Elizabeth L Holzschuh; Jennifer Lloyd; Joseph Scaletta; Anne Straily; Sheri Tubach; Ashley Willingham; W Allan Nix; M Steven Oberste; Christopher J Harrison; Charles Hunt; George Turabelidze; Susan I Gerber; John T Watson Journal: J Pediatric Infect Dis Soc Date: 2018-05-15 Impact factor: 3.164
Authors: Eveline P de Jong; Herma C Holscher; Sylke J Steggerda; Jeanine M M Van Klink; Erika P M van Elzakker; Enrico Lopriore; Frans J Walther; Frank Brus Journal: Eur J Pediatr Date: 2017-09-10 Impact factor: 3.183
Authors: André Kidszun; Lena Klein; Julia Winter; Isabella Schmeh; Britta Gröndahl; Stephan Gehring; Markus Knuf; Kerstin Weise; Eva Mildenberger Journal: Am J Perinatol Date: 2016-05-16 Impact factor: 1.862