Pediatrics and Neonatology最新文献_第6页

The efficacy and safety of intravenous immunoglobulin infusion in 12 h for the initial treatment of Kawasaki disease 12 小时内静脉注射免疫球蛋白用于川崎病初期治疗的有效性和安全性。

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2023.09.012

Background

Approximately 10–20 % of individuals develop a recrudescent or persistent fever after intravenous immunoglobulin (IVIG) infusion for the initial treatment of Kawasaki disease. The aim of this study was to evaluate the efficacy and safety of the initial IVIG treatment of Kawasaki disease based on duration of infusion.

Methods

This retrospective, single-center study included 53 patients with Kawasaki disease who were initially treated with 2 g/kg of IVIG by means of a single infusion from June 2018 to August 2019. We classified patients into two groups based on the duration of the infusion: the 12-h group and the 24-h group. We compared the treatment response of the primary IVIG and its adverse events using the Mann-Whitney U test and Fisher's exact or Chi-square tests.

Results

There were no significant differences in the response to initial IVIG treatment between the two groups. The duration from treatment onset to defervescence was shorter in the 12-h group than the 24-h group (7 h vs. 12 h, respectively, p = 0.07); however, this was not significant. There were no significant between-group differences regarding adverse events.

Conclusion

We concluded that the initial 12-h IVIG treatment was comparable to the 24-h treatment in terms of efficacy and safety. This will enable physicians to feel confident about pursuing a shorter course of treatment with similar results as conventional treatment and decide on administering additional therapy to their patients.

背景：约有10%-20%的患者在输注静脉免疫球蛋白（IVIG）初始治疗川崎病后出现复发或持续发热。本研究的目的是根据输注持续时间评估川崎病初始 IVIG 治疗的有效性和安全性：这项回顾性单中心研究纳入了 2018 年 6 月至 2019 年 8 月期间通过单次输注 2 g/kg IVIG 进行初始治疗的 53 例川崎病患者。我们根据输注持续时间将患者分为两组：12 小时组和 24 小时组。我们使用 Mann-Whitney U 检验和 Fisher's exact 或 Chi-square 检验比较了主要 IVIG 的治疗反应及其不良事件：结果：两组患者对初始 IVIG 治疗的反应无明显差异。12小时组从治疗开始到恢复期的持续时间比24小时组短（分别为7小时和12小时，P = 0.07），但差异不显著。在不良反应方面，组间差异不明显：我们的结论是，就疗效和安全性而言，最初的 12 小时 IVIG 治疗与 24 小时治疗相当。这将使医生能够放心地采用疗程更短且效果与常规治疗相似的治疗方法，并决定对患者进行额外治疗。

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引用次数: 0

Corticosteroid use in neonatal hypotension: A survey of Canadian neonatologists 新生儿低血压时皮质类固醇的使用：加拿大新生儿科医生调查

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2023.09.013

Objective

To assess prescribing practices and perspectives regarding the use of corticosteroids in the management of neonatal hypotension.

Methods

Cross-sectional questionnaire-based electronic survey of neonatologists (n = 206) practicing at tertiary neonatal intensive care units across 30 academic centres in Canada.

Results

The overall response rate was 33% (72/206), with a completion rate was 94%. Most (48/72, 64%) worked in a unit that covered both inborn and outborn infants, and 53% (37/70) worked in units with >100 very low birth weight infants admitted annually. Among the 72 respondents, 39% use a loading dose, of whom most (57%) use 2 mg/kg. Dosing ranges were variable, most using either 0.5 mg/kg or 1 mg/kg, q6h. Among the 56% (40/72) of neonatologists who reported measuring cortisol before initiation of hydrocortisone, cut-offs for initiation of hydrocortisone varied from <100 to <500 nmol/L, most of whom (48%) used <100 nmol/L. Of 71 respondents, 92% (65) indicated that a randomized control trial examining the use of corticosteroids in neonatal hypotension is needed, of whom 52% (37) indicated that the intervention group should receiving hydrocortisone after one vasopressor/inotrope.

Conclusions

This survey provides insight into the prescribing practices of tertiary neonatologists with regards to the use of corticosteroids in neonatal hypotension. While corticosteroids are frequently prescribed, there is variability in the indication, dosing, and duration of corticosteroid use. The findings from this survey can be used to inform further research, including a clinical trial, regarding the practice in the management of neonatal hypotension.

评估使用皮质类固醇治疗新生儿低血压的处方做法和观点。对加拿大 30 个学术中心的三级新生儿重症监护病房的新生儿科医生（n = 206）进行横断面电子问卷调查。总回复率为 33%（72/206），完成率为 94%。大多数受访者（48/72，64%）所在的科室同时收治新生儿和非新生儿，53%（37/70）的受访者所在的科室每年收治的超低出生体重儿超过 100 名。在 72 位受访者中，39% 使用负荷剂量，其中大多数（57%）使用 2 毫克/千克。剂量范围不一，大多数人使用 0.5 毫克/千克或 1 毫克/千克，每 6 小时一次。56%（40/72）的新生儿科医生报告在开始使用氢化可的松前测量过皮质醇，其中开始使用氢化可的松的临界值从<100到<500 nmol/L不等，大多数医生（48%）使用<100 nmol/L。在 71 位受访者中，92%（65 位）表示需要进行随机对照试验，研究皮质类固醇在新生儿低血压中的应用，其中 52%（37 位）表示干预组应在使用一次血管加压素/肌注后再使用氢化可的松。这项调查有助于了解三级新生儿科医生在新生儿低血压时使用皮质类固醇的处方做法。虽然皮质类固醇经常被开具处方，但在皮质类固醇的使用指征、剂量和持续时间方面存在差异。这项调查的结果可用于进一步研究新生儿低血压的治疗方法，包括临床试验。

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引用次数: 0

Predictors of high maintenance prostaglandin E1 doses in neonates with critical congenital heart disease-ductal-dependent pulmonary circulation during preoperative care 危重先天性心脏病--传导依赖性肺循环新生儿术前护理期间前列腺素 E1 高维持剂量的预测因素

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2024.01.002

Background

Neonates with critical congenital heart disease of the ductal-dependent pulmonary circulation type (CCHD-DDPC) require prostaglandin E1 (PGE1) to maintain oxygen saturation until surgery. However, the factors contributing to the maintenance doses of PGE1 remain unclear. This study aimed to determine the predictors of high maintenance PGE1 doses in these neonates.

Methods

This retrospective cohort study included neonates with CCHD-DDPC at Songklanagarind Hospital between January 1, 2006, and December 31, 2021. Factors associated with high maintenance PGE1 doses (> 0.01 mcg/kg/min) were analyzed to identify predictors. Odds ratios were calculated using tabulation and logistic regression analysis. A prediction score was developed for high maintenance PGE1 doses.

Results

Among 96 neonates with CCHD-DDPC, 55 % required high maintenance doses of PGE1. Three factors significantly associated with high maintenance PGE1 doses were patent ductus arteriosus (PDA) size-to-birthweight ratio ≤1.3 mm/kg, initial PGE1 dose >0.03 mcg/kg/min, and preoperative invasive mechanical ventilation. The area under the receiver operating characteristic curve for these three predictors was 0.7409. A predictive score of 0–3 was created based on these factors. The probabilities of receiving a high maintenance dose of PGE1 for patients with overall scores of 0, 1, 2, and 3 were 0.19 (95 % CI: 0.04–0.33), 0.42 (95 % CI: 0.30–0.54), 0.69 (95 % CI: 0.57–0.81), and 0.87 (95 % CI: 0.76–0.99), respectively.

Conclusions

In neonates with CCHD-DDPC, a PDA size-to-birth weight ratio ≤1.3 mm/kg, an initial dose of PGE1 > 0.03 mcg/kg/min, and preoperative invasive mechanical ventilation were predictors of high maintenance PGE1 doses during the preoperative period.

背景患有导管依赖性肺循环型危重先天性心脏病（CCHD-DDPC）的新生儿需要前列腺素E1（PGE1）来维持血氧饱和度，直至手术。然而，导致 PGE1 维持剂量的因素仍不清楚。这项回顾性队列研究纳入了 2006 年 1 月 1 日至 2021 年 12 月 31 日期间在松克拉加林医院接受 CCHD-DDPC 治疗的新生儿。研究分析了与高维持PGE1剂量（0.01 mcg/kg/min）相关的因素，以确定预测因素。通过制表和逻辑回归分析计算出了几率比。结果在96名患有CCHD-DDPC的新生儿中，55%需要高剂量的PGE1维持治疗。与PGE1高维持剂量明显相关的三个因素是动脉导管未闭（PDA）大小与体重之比≤1.3 mm/kg、初始PGE1剂量为0.03 mcg/kg/min和术前有创机械通气。这三个预测因子的接收器操作特征曲线下面积为 0.7409。根据这些因素得出了 0-3 的预测分数。综合评分为 0、1、2 和 3 的患者接受大剂量 PGE1 的概率分别为 0.19（95 % CI：0.04-0.33）、0.42（95 % CI：0.30-0.54）、0.69（95 % CI：0.57-0.81）和 0.87（95 % CI：0.76-0.99）。结论在患有CCHD-DDPC的新生儿中，PDA尺寸与出生体重之比≤1.3 mm/kg、PGE1初始剂量为0.03 mcg/kg/min、术前有创机械通气是术前维持高PGE1剂量的预测因素。

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引用次数: 0

Using a survey, analyzing the current situation of allergic March in elementary and junior high school students of oyama and tochigi cities, Japan 通过调查，分析日本大山市和栃木市中小学生过敏性三月症的现状。

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2023.10.008

Background

Over the past few decades, allergic diseases have become more prevalent and impact around 20% of the global population. There is clinical significance of allergic march as it places a burden on the quality of life of children and their families.

Objectives

To assess the current situation of allergy conditions experienced by children attending elementary and junior high schools in Oyama and Tochigi cities, Japan.

Methods

A letter was sent to parents informing them about an opt-in online survey concerning children's allergies along with a weblink and a QR code. A video explained the survey process and informed parents that their replies could not be retracted. Parents who had watched the explanation video and answered yes to participating were considered to have provided consent for the survey.

Results

A total of 2038 valid replies were gathered. Allergic Rhinitis was the most commonly diagnosed allergy, followed by Asthma, Food Allergy, and Atopic Dermatitis. Around 70% of the children were affected by the allergies, of whom half had been affected by multiple allergies. Most children affected by Atopic Dermatitis, Food Allergy or Asthma were affected by other allergies. Atopic Dermatitis and Food Allergy were mostly diagnosed before Asthma and Allergic Rhinitis.

Conclusions

Children who are diagnosed with either Atopic Dermatitis or a Food Allergy will likely be affected by other allergies later in life. Allergic march perpetuated an earlier peak diagnosis incident rate for allergic rhinitis. Allergic Rhinitis can occur independently from other allergies compared to Atopic Dermatitis, Food Allergy and Asthma.

背景：过去几十年来，过敏性疾病越来越普遍，影响了全球约 20% 的人口。过敏性疾病对儿童及其家庭的生活质量造成了负担，因此具有重要的临床意义：评估日本大山市和栃木市小学和初中儿童的过敏症现状：方法：向家长发送一封信，告知他们可以选择参与有关儿童过敏症的在线调查，信中附有一个网络链接和一个二维码。一段视频解释了调查过程，并告知家长他们的答复不能撤回。观看了解释视频并回答 "是 "的家长被视为同意参与调查：共收集到 2038 份有效答卷。过敏性鼻炎是最常见的过敏症，其次是哮喘、食物过敏和特应性皮炎。约 70% 的儿童受到过敏症的影响，其中一半儿童受到多种过敏症的影响。大多数患有特应性皮炎、食物过敏或哮喘的儿童还患有其他过敏症。特应性皮炎和食物过敏大多先于哮喘和过敏性鼻炎确诊：结论：被诊断出患有特应性皮炎或食物过敏的儿童很可能会在以后的生活中受到其他过敏症的影响。过敏性游行使过敏性鼻炎的诊断高峰期提前。与特应性皮炎、食物过敏和哮喘相比，过敏性鼻炎可独立于其他过敏症而发生。

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引用次数: 0

Protective effect of breastfeeding on Kawasaki disease: A systemic review and meta-analysis 母乳喂养对川崎病的保护作用：系统回顾与荟萃分析。

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2024.03.001

Background

Previous research has indicated a negative correlation between exclusive breastfeeding and the incidence of Kawasaki disease (KD). However, the validation of this discovery through meta-analytical studies has been lacking. Furthermore, uncertainties persist regarding whether breastfeeding reduces the risk of coronary artery lesions (CAL) or resistance to intravenous immunoglobulin (IVIG).

Methods

A systematic exploration of the MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and ClinicalTrials.gov databases was conducted to identify longitudinal or randomized controlled trials investigating the efficacy of breastfeeding in preventing KD. The primary focus was on the incidence of KD, with secondary emphasis placed on the incidence of CAL and IVIG resistance. Data were pooled using a frequentist-restricted maximum-likelihood random-effects model.

Results

Of the 179 potentially eligible studies identified, five (n = 1,982,634) were included. The analysis revealed a significantly lower risk of KD (expressed as odds ratio, with 95% confidence intervals and p-values) in comparisons between exclusive breastfeeding and formula feeding (0.62, 0.43−0.91, p = 0.014), exclusive breastfeeding/partial breastfeeding and formula feeding (0.66, 0.46− 0.96, p = 0.03), and exclusive breastfeeding and partial breastfeeding/formula feeding (0.81, 0.74− 0.90, p < 0.01). However, no significant difference was observed in the risk of developing KD when comparing partial breastfeeding to formula feeding exclusively. Regarding secondary outcomes, no statistically significant difference was found in the risk of CAL or IVIG resistance across any comparison formats.

Conclusions

Our study suggests that breastfeeding correlated with a reduced risk of KD but not with a reduced risk of CAL or IVIG resistance. These findings advocate for the implementation of breastfeeding policies in clinical practice.

背景以前的研究表明，纯母乳喂养与川崎病（KD）的发病率呈负相关。然而，这一发现尚未通过荟萃分析研究得到验证。此外，关于母乳喂养是否会降低冠状动脉病变（CAL）的风险或对静脉注射免疫球蛋白（IVIG）的抵抗力，仍存在不确定性。方法：对MEDLINE、Cochrane对照试验中央注册中心（CENTRAL）、PubMed、EMBASE和ClinicalTrials.gov数据库进行了系统性探索，以确定调查母乳喂养对预防KD疗效的纵向或随机对照试验。试验的主要重点是 KD 的发病率，其次是 CAL 和 IVIG 抗药性的发病率。结果在确定的 179 项可能符合条件的研究中，有 5 项（n=1,982,634）被纳入。分析结果显示，在纯母乳喂养和配方奶粉喂养（0.62，0.43-0.91，p = 0.014）、纯母乳喂养/部分母乳喂养和配方奶粉喂养（0.66，0.46- 0.96，p = 0.03）以及纯母乳喂养和部分母乳喂养/配方奶粉喂养（0.81，0.74- 0.90，p <0.01）之间的比较中，KD风险明显较低（以几率比表示，含95%置信区间和p值）。然而，部分母乳喂养与完全配方奶喂养相比，患 KD 的风险没有明显差异。结论我们的研究表明，母乳喂养与 KD 风险的降低有关，但与 CAL 或 IVIG 耐药风险的降低无关。这些发现提倡在临床实践中实施母乳喂养政策。

{"title":"Protective effect of breastfeeding on Kawasaki disease: A systemic review and meta-analysis","authors":"","doi":"10.1016/j.pedneo.2024.03.001","DOIUrl":"10.1016/j.pedneo.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><p>Previous research has indicated a negative correlation between exclusive breastfeeding and the incidence of Kawasaki disease (KD). However, the validation of this discovery through meta-analytical studies has been lacking. Furthermore, uncertainties persist regarding whether breastfeeding reduces the risk of coronary artery lesions (CAL) or resistance to intravenous immunoglobulin (IVIG).</p></div><div><h3>Methods</h3><p><u>A systematic exploration of</u> the MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> databases was conducted to identify longitudinal or randomized controlled trials investigating the efficacy of breastfeeding in preventing KD. The primary focus was on the incidence of KD, with secondary emphasis placed on the incidence of CAL and IVIG resistance. Data were pooled using a frequentist-restricted maximum-likelihood random-effects model.</p></div><div><h3>Results</h3><p>Of the 179 potentially eligible studies identified, five (n = 1,982,634) were included. The analysis revealed a significantly lower risk of KD (expressed as odds ratio, with 95% confidence intervals and p-values) in comparisons between exclusive breastfeeding and formula feeding (0.62, 0.43−0.91, <em>p</em> = 0.014), exclusive breastfeeding/partial breastfeeding and formula feeding (0.66, 0.46− 0.96, <em>p</em> = 0.03), and exclusive breastfeeding and partial breastfeeding/formula feeding (0.81, 0.74− 0.90, <em>p</em> < 0.01). However, no significant difference was observed in the risk of developing KD when comparing partial breastfeeding to formula feeding exclusively. Regarding secondary outcomes, no statistically significant difference was found in the risk of CAL or IVIG resistance across any comparison formats.</p></div><div><h3>Conclusions</h3><p>Our study suggests that breastfeeding correlated with a reduced risk of KD but not with a reduced risk of CAL or IVIG resistance. These findings advocate for the implementation of breastfeeding policies in clinical practice.</p></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 5","pages":"Pages 427-434"},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1875957224000445/pdfft?md5=09b21872c98e81b76ed4e98931d73e71&pid=1-s2.0-S1875957224000445-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development and validation of a nomogram to predict intracranial haemorrhage in neonates 开发和验证用于预测新生儿颅内出血的提名图。

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2024.02.005

Background

The aim of this study was to establish and validate a Susceptibility-weighted imaging (SWI)-based predictive model for neonatal intracranial haemorrhage (ICH).

Methods

A total of 1190 neonates suspected of ICH after cranial ultrasound screening in a tertiary hospital were retrospectively enrolled. The neonates were randomly divided into a training cohort and a internal validation cohort by a ratio of 7:3. Univariate analysis was used to analyze the correlation between risk factors and ICH, and the prediction model of neonatal ICH was established by multivariate logistic regression based on minimum Akaike information criterion (AIC). The nomogram was externally validated in another tertiary hospital of 91 neonates. The performance of the nomogram was evaluated in terms of discrimination by the area under the curve (AUC), calibration by the calibration curve and clinical net benefit by the decision curve analysis (DCA).

Results

Univariate analysis and min AIC-based multivariate logistic regression screened the following variables to establish a predictive model for neonatal ICH: Platelet count (PLT), gestational diabetes, mode of delivery, amniotic fluid contamination, 1-min Apgar score. The AUC was 0.715, 0.711, and 0.700 for the training cohort, internal validation cohort, and external validation cohort, respectively. The calibration curve showed a good correlation between the nomogram prediction and actual observation for ICH. DCA showed the nomogram was clinically useful.

Conclusion

We developed and validated an easy-to-use nomogram to predict ICH for neonates. This model could support individualized risk assessment and healthcare.

背景：本研究的目的是建立并验证基于感度加权成像（SWI）的新生儿颅内出血（ICH）预测模型：本研究旨在建立并验证基于感度加权成像（SWI）的新生儿颅内出血（ICH）预测模型：方法：回顾性纳入了一家三级医院的 1190 名经头颅超声筛查疑似 ICH 的新生儿。新生儿按 7:3 的比例随机分为训练组和内部验证组。采用单变量分析方法分析危险因素与 ICH 之间的相关性，并根据最小阿凯克信息准则（AIC）通过多变量逻辑回归建立新生儿 ICH 预测模型。在另一家三级医院对 91 名新生儿进行了外部验证。根据曲线下面积（AUC）、校准曲线和决策曲线分析（DCA）对提名图的区分度、校准和临床净效益进行了评估：单变量分析和基于 min AIC 的多变量逻辑回归筛选了以下变量，以建立新生儿 ICH 的预测模型：血小板计数（PLT）、妊娠糖尿病、分娩方式、羊水污染、1 分钟 Apgar 评分。训练队列、内部验证队列和外部验证队列的AUC分别为0.715、0.711和0.700。校准曲线显示，提名图预测结果与 ICH 实际观察结果之间具有良好的相关性。DCA显示提名图在临床上是有用的：我们开发并验证了一种易于使用的新生儿 ICH 预测提名图。该模型可为个体化风险评估和医疗保健提供支持。

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引用次数: 0

Hemoperitoneum presenting as hypovolemic shock in an extremely premature infant – Case report and review of literature 以低血容量休克为表现形式的极早产儿腹腔积血--病例报告和文献综述

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2024.03.002

引用次数: 0

Lessons from two patients with Prader–Willi syndrome attributed to heterodisomy and isodisomy 从两名因异位二体和同位二体造成的普拉德-威利综合征患者身上汲取的教训

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2024.06.002

引用次数: 0

3D computed tomography diagnosis of Klippel-Feil syndrome and Sprengel's deformity with omovertebral bone 三维计算机断层扫描诊断 Klippel-Feil 综合征和 Sprengel's畸形的外椎骨。

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2024.06.004

引用次数: 0

Investigation of gut microbiota diversity according to infectious agent in pediatric infectious acute gastroenteritis in a Korean university hospital 韩国一家大学医院根据感染病原体调查儿科感染性急性肠胃炎患者肠道微生物群的多样性。

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology

Pub Date : 2024-09-01 DOI: 10.1016/j.pedneo.2024.01.005

Background

Acute gastroenteritis (AGE) is a common cause of pediatric morbidity and mortality worldwide. AGE can cause an imbalance in the intestinal microbiota. This study aimed to investigate the diversity of the gut microbiome in Korean children hospitalized for infectious AGE at a university hospital.

Methods

A total of 23 stool samples from patients aged 5 months to 11 years with AGE were analyzed. Thirteen convalescent stool samples were collected 1 month after discharge. Multiplex polymerase chain reaction (PCR) for the five viruses and 16 bacteria-specific AGE pathogens (PowerChek Multiplex Real time PCR Kit, Seoul, Korea), and 16s rRNA sequencing (Illumina MiSeq Sequencing system, Illumina, USA) were performed.

Results

According to the results of multiplex PCR for causative pathogens, the microbiome taxonomic profile (MTP) of the gut microbiome in three groups of AGE, norovirus AGE (n = 11), Campylobacter AGE (n = 7) and Salmonella AGE (n = 5) was compared. The phylum Actinobacteria was significantly more abundant in the norovirus AGE (P = 0.011), whereas the phylum Proteobacteria was significantly more abundant in Salmonella AGE (P = 0.012). Alpha diversity, which indicates species richness and diversity, showed no statistical differences. However, beta diversity, representing the similarity in MTP between norovirus, Campylobacter, and Salmonella AGE, was significantly different (P = 0.007). In convalescence, compared with their corresponding AGE samples, the phylum Firmicutes; and the lower taxa Christensenellaceae (P = 0.0152) and Lachnospiraceae (P = 0.0327) were significantly increased.

Conclusions

In pediatric AGE, the type of infectious agent can affect the diversity and dominance of gut microbiota in pediatric patients. Furthermore, healthy gut bacteria increased during the period of 1 month after infection, allowing a return to a healthy state without causing long-term dysbiosis.

背景：急性肠胃炎（AGE）是全球儿童发病和死亡的常见原因。AGE 可导致肠道微生物群失衡。本研究旨在调查在一家大学医院因感染性 AGE 而住院的韩国儿童肠道微生物组的多样性：分析了 23 份粪便样本，这些样本来自 5 个月至 11 岁的 AGE 患者。出院 1 个月后收集了 13 份康复粪便样本。对 5 种病毒和 16 种细菌特异性 AGE 病原体（PowerChek Multiplex Real time PCR Kit，韩国首尔）进行多重聚合酶链反应（PCR），并对 16s rRNA 进行测序（Illumina MiSeq 测序系统，美国 Illumina 公司）：结果：根据致病菌的多重 PCR 结果，比较了三组 AGE（诺如病毒 AGE（n = 11）、弯曲杆菌 AGE（n = 7）和沙门氏菌 AGE（n = 5））的肠道微生物组分类概况（MTP）。诺如病毒 AGE 中放线菌门的数量明显较多（P = 0.011），而沙门氏菌 AGE 中变形菌门的数量明显较多（P = 0.012）。表示物种丰富度和多样性的α多样性没有显示出统计学差异。然而，代表诺如病毒、弯曲杆菌和 AGE 沙门氏菌之间 MTP 相似性的贝塔多样性却有显著差异（P = 0.007）。与相应的 AGE 样本相比，康复期样本中的真菌门、低等类群克里斯滕森菌科（P = 0.0152）和拉赫诺斯皮拉菌科（P = 0.0327）明显增加：结论：在小儿 AGE 中，感染病原体的类型会影响小儿患者肠道微生物群的多样性和优势。此外，健康的肠道细菌在感染后的 1 个月内有所增加，可恢复到健康状态，而不会导致长期的菌群失调。

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引用次数: 0