Clinical Characteristics and Genotype of Rotavirus Infection in Newborn Infants / 대한주산의학회잡지

PURPOSE: This study was conducted to investigate the incidence of rotavirus infection and common rotavirus strains of newborn infants admitted to the NICU and elucidate association, between rotavirus infection and clinical symptoms, and the significance of rotavirus antigen test. METHODS: From July 2010 to June 2011, stools of 408 newborns admitted into the NICU were tested for rotavirus antigen by enzyme-linked fluorescent assay. Rotavirus positive stools were performed RT-PCR. RESULTS: A total of 408 stool samples were examined by VIDAS Rotavirus(R), and 128 specimens (31.4%) were proven positive. One hundred thirteen fecal specimens were eligible for RT-PCR and rotavirus was detected in 42 samples (10.3%). PCR (+) prevalence of antigen positive infants was significantly lower in 1-2 postnatal days group than infants older than three days after birth (P<0.001). Out of the 42 PCR positive infants, there were 26 (62%) symptomatic infants. Seventeen infants had fever, 15 had diarrhea, and 3 experienced vomiting. Rest of the 16 patients (38%) did not show any symptoms. The most common strain was G4P[6] (n=40, 95.2%), followed by G4P[8] (n=1, 2.4%), and G3P[3] (n=1, 2.4%). CONCLUSIONS: Rotavirus infection rate in the NICU was 31.4% in the antigen test and 11.7% in the PCR test. False positive rate of rotavirus antigen test was significantly higher in 1-2 postnatal days group. Thus, it should be considered to apply different RFV standards from adults when rotavirus antigen test result is evaluated in newborn infants. The most common strain of rotavirus was G4P[6].

The Clinical Characteristics According to the Risk Factors of Idiopathic Nonhemolytic Hyperbilirubinemia

PURPOSE: Hospital readmissions have recently increased due to early hospital discharge and increased trends in breast-feeding. Neonatal hyperbilirubinemia can lead to fatal permanent neurological sequelae without appropriate management. Early detection and intervention are critical. We evaluated the clinical features, risk factors, and brain MRI findings of Korean newborns with idiopathic nonhemolytic hyperbilirubinemia to determine the optimal management policy. METHODS: A retrospective review of the medical records of 79 newborns with idiopathic nonhemolytic hyperbilirubinemia was performed at the NICU of the Kyungpook National University Hospital from January 2006 to September 2009. All patients were 35 or more weeks of gestation, and their peak level of serum total bilirubin was more than 20 mg/dL. RESULTS: The mean gestational age was 38(+3)+/-1(+4) weeks, and the mean age on admission was 8.8+/-4.0 days. The mean body weight (3,105+/-479 g) was decreased by 2.8+/-6.4 percent compared to the mean birth weight (3,174+/-406 g). There were no statistically significant differences for the peak serum bilirubin level or the duration and effects of phototherapy between the patients with and without risk factors, which included: breastfeeding, cephalohematoma, subdural hemorrhage, and/or ABO incompatibility. Patients were grouped according to change of body weight. Group I consisted of patients that gained weight compared to birth weight, and group II of patients that lost weight compared to birth weight. There were significant differences in the peak serum total bilirubin level between the two groups. Thirty nine patients had brain MRI evaluation; 21 patients had bilateral symmetric signal intensity increases in the globus pallidus compared to adjacent corticospinal tract and putamen on T1-weighted images. CONCLUSION: Bilirubin encephalopathy is preventable with early screening and proper management. Parents require instruction on feeding practices and follow-up to prevent complications from idiopathic nonhemolytic hyperbilirubinemia.

The Clinical Characteristics According to the Risk Factors of Idiopathic Nonhemolytic Hyperbilirubinemia

PURPOSE: Hospital readmissions have recently increased due to early hospital discharge and increased trends in breast-feeding. Neonatal hyperbilirubinemia can lead to fatal permanent neurological sequelae without appropriate management. Early detection and intervention are critical. We evaluated the clinical features, risk factors, and brain MRI findings of Korean newborns with idiopathic nonhemolytic hyperbilirubinemia to determine the optimal management policy. METHODS: A retrospective review of the medical records of 79 newborns with idiopathic nonhemolytic hyperbilirubinemia was performed at the NICU of the Kyungpook National University Hospital from January 2006 to September 2009. All patients were 35 or more weeks of gestation, and their peak level of serum total bilirubin was more than 20 mg/dL. RESULTS: The mean gestational age was 38(+3)+/-1(+4) weeks, and the mean age on admission was 8.8+/-4.0 days. The mean body weight (3,105+/-479 g) was decreased by 2.8+/-6.4 percent compared to the mean birth weight (3,174+/-406 g). There were no statistically significant differences for the peak serum bilirubin level or the duration and effects of phototherapy between the patients with and without risk factors, which included: breastfeeding, cephalohematoma, subdural hemorrhage, and/or ABO incompatibility. Patients were grouped according to change of body weight. Group I consisted of patients that gained weight compared to birth weight, and group II of patients that lost weight compared to birth weight. There were significant differences in the peak serum total bilirubin level between the two groups. Thirty nine patients had brain MRI evaluation; 21 patients had bilateral symmetric signal intensity increases in the globus pallidus compared to adjacent corticospinal tract and putamen on T1-weighted images. CONCLUSION: Bilirubin encephalopathy is preventable with early screening and proper management. Parents require instruction on feeding practices and follow-up to prevent complications from idiopathic nonhemolytic hyperbilirubinemia.