早产儿产后巨细胞病毒感染。

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES
Current Opinion in Infectious Diseases Pub Date : 2024-10-01 Epub Date: 2024-07-31 DOI:10.1097/QCO.0000000000001047
Karen M Puopolo
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引用次数: 0

摘要

审查目的:尽管母乳喂养对极低出生体重、低妊娠的婴儿有多种益处,但巨细胞病毒(CMV)血清反应阳性母亲所生的婴儿有感染产后 CMV 的风险。本综述将介绍极早产儿产后感染 CMV 的风险和后果:最新发现:产后 CMV 可表现为临床上无症状的感染,也可表现为轻度至重度的疾病,偶尔也可导致死亡。早产儿母乳喂养对健康的益处平衡了疾病风险。产后 CMV 感染与多种早产儿发病风险增加有关,如支气管肺发育不良、坏死性小肠结肠炎和神经发育障碍,但目前的证据受到病例系列报告和回顾性队列研究中固有的选择偏差的限制。摘要:在巴氏灭菌法灭活新鲜母乳中的 CMV 的风险-效益平衡方面,以及用抗病毒药物治疗受感染婴儿的最佳剂量、持续时间和疗效方面,存在知识差距。目前急需开展多中心、前瞻性研究,以准确确定产后 CMV 感染给早产儿带来的真正负担。这些研究将为制定预防策略和治疗指南提供依据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postnatally acquired cytomegalovirus infection among preterm infants.

Purpose of review: Although there are multiple benefits of mother's own milk feeding for very-low birth weight, low gestation infants, those born to cytomegalovirus (CMV)-seropositive mothers are at risk for acquiring postnatal CMV infection. This review will describe the risk and consequences of postnatal CMV infection among very preterm infants.

Recent findings: Postnatal CMV may manifest as clinically silent infection or as mild to severe and occasionally fatal disease. The risk of disease is balanced by the health benefits of human milk feeding to preterm infants. Postnatal CMV infection has been associated with increased risks of multiple preterm morbidities such as bronchopulmonary dysplasia, necrotizing enterocolitis and neurodevelopmental impairment, but current evidence is limited by the selection bias inherent to reporting in case series and retrospective cohort studies.

Summary: Knowledge gaps exist regarding the risk-benefit balance of pasteurization to inactivate CMV in fresh breast milk, as well as the optimal dosing, duration and efficacy of treating infected infants with antiviral medications. Multicenter, prospective studies are urgently needed to accurately determine the true burden that postnatal CMV infection presents to very preterm infants. Such studies will inform the need for preventive strategies and treatment guidance.

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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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