A population-based prospective survey of newborn infants with suspected systemic infection: occurrence of sporadic enterovirus and adenovirus infections

Background: Enterovirus outbreaks are known to occur in neonatal wards and enteroviruses may cause community-acquired sepsis-like disease in the neona tal period. Less well is known their possible role in suspected systemic in fections during the perinatal period. Objectives: To investigate the occurrence of enterovirus infections in neon atal patients suspected of systemic infection. Study design: A population-based prospective survey was organized in the ho spitals of the Greater Helsinki Region during 13 months in 1993-94. Criteri a for enrollment included onset of symptoms before the age of 29 days and a decision, on clinical grounds, to take a blood culture for bacteria. Acute phase samples of blood, feces, nasopharyngeal swab, and cerebrospinal flui d, if available, were inoculated in monolayer cultures of four different ce ll lines. In addition, enterovirus infections were searched for using group -reacting IgM test. Results: One hundred and thirty-seven patients had a sumcient number of spe cimens examined, and were thus evaluable. Most of the infants had the onset of the symptoms within a few days after birth. An enterovirus was isolated from four newborn infants (3%), while seven children (5%) were found to ex crete adenovirus. Enteroviral antigen was detected in cell cultures inocula ted with specimens from two additional infants. Virus-positive infants had no evidence of bacterial infection and did not show specific clinical signs or symptoms differentiating them from the rest of the study group. All enr olled infants recovered without sequelae. Conclusion: We conclude that sporadic viral infections may be common in neo natal patients with suspected systemic infection, and this should be taken into account when judging the etiology. (C) 1999 Elsevier Science B.V. All rights reserved.