Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Influenza A Outbreak in a Neonatal Intensive Care Unit During the 2011-2012 Influenza Season in Korea

2011-2012년 인플루엔자 국내 유행시기에 신생아 중환자실에서 발생한 A형 인플루엔자 바이러스 집단발병

  • Son, Ok Sung (Department of Pediatrics, Kosin University College of Medicine) ;
  • Oh, Chi Eun (Department of Pediatrics, Kosin University College of Medicine) ;
  • Kong, Seom Gim (Department of Pediatrics, Kosin University College of Medicine) ;
  • Jung, Yu Jin (Department of Pediatrics, Kosin University College of Medicine) ;
  • Hong, Yoo Rha (Department of Pediatrics, Kosin University College of Medicine)
  • 손옥성 (고신대학교 의과대학 소아과학교실) ;
  • 오지은 (고신대학교 의과대학 소아과학교실) ;
  • 공섬김 (고신대학교 의과대학 소아과학교실) ;
  • 정유진 (고신대학교 의과대학 소아과학교실) ;
  • 홍유라 (고신대학교 의과대학 소아과학교실)
  • Received : 2015.09.16
  • Accepted : 2015.11.03
  • Published : 2016.08.25
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Abstract

Purpose: An outbreak of influenza virus is uncommon in neonatal intensive care unit (NICU). The clinical presentation of influenza virus infection in neonates is diverse. This study was aimed to report an outbreak of influenza A in a NICU and to investigate the clinical characteristics of influenza virus infection in neonates especially preterm infants during the 2011-2012 influenza season in Korea. Methods: We reviewed the medical records of 29 patients who were evaluated by respiratory virus multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) at NICU of Kosin University Gospel Hospital during the 2011-2012 seasonal influenza outbreak in Korea. Results: Eleven patients (37.9%) were influenza A virus RT-PCR positive during the survey periods. They were all preterm infants and three of them had no symptoms. Eight patients had symptoms and it was fever (18%, 2/11), respiratory difficulty (72.7%, 8/11) without symptoms of upper respiratory infection, and gastrointestinal symptoms (27.3%, 3/11). The median duration of symptom was 5 days. There were differences of duration of admission at the test of respiratory RT-PCR, Clinical Risk Index for Babies (CRIB) score, use of mechanical ventilation, and use of dexamethasone before infection between influenza A virus RT-PCR positive and negative group. All 11 patients with influenza A were discharged without any complications. Conclusions: The symptoms of influenza A virus infection in the preterm infants is nonspecific. Influenza A virus should be considered as a possible cause of infection in NICU during the influenza season in the community.

목적: 신생아 중환자실(neonatal intensive care unit, NICU)에서 인플루엔자 바이러스 집단 발병의 보고는 흔하지 않으며 그 증상은 다양하다. 저자들은 국내 단일기관 NICU에서 발생한 A형 인플루엔자 바이러스 감염의 집단발병에 대해 보고하고 신생아 특히 미숙아에서의 임상적 특성을 알아보고자 하였다. 방법: 2011-2012년 국내 인플루엔자 바이러스 감염 유행 시기에 고신대학교 복음병원 NICU에 입원한 환자들 중 인플루엔자 바이러스 RT-PCR 검사를 시행한 29명 환자들의 의무기록을 후향적으로 조사하였다. 결과: 대상 환자 중 11명에서 A형 인플루엔자 바이러스 양성이었는데(37.9%), 모두 미숙아였고 이들 중 3명(27%)은 증상이 없었으며 상기도 감염 증상 없이, 발열(18%, 2/11), 호흡곤란(72.7%, 8/11), 소화기 증상(27.3%, 3/11)이 있었다. 증상 소실까지 기간의 중앙값은 5일이었다. 이들은 모두 합병증 없이 생존하여 퇴원하였다. A형 인플루엔자 바이러스 RT-PCR 양성군과 음성군 사이에 검체 채취시 재원기간, CRIB 점수, 기계환기 과거력, 덱사메타손 사용 과거력의 차이가 있었다. 결론: 신생아 특히 미숙아에서 A형 인플루엔자 바이러스 감염의 증상은 비특이적이므로 지역 내 인플루엔자 유행시기에는 NICU 입원 중인 신생아에서 감염질환의 원인 병원체로 인플루엔자 바이러스를 고려해야 한다.

Keywords

References

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