Neonatal epidemic diarrhea

　　The main causes of neonatal epidemic diarrhea are as follows:

　　1, Bacteria

　　Among pathogenic bacteria, Escherichia coli is relatively common. Pathogenic Escherichia coli, toxigenic Escherichia coli, and hemorrhagic Escherichia coli have all caused neonatal epidemic diarrhea. Salmonella typhimurium is also an important pathogen of epidemic diarrhea. Salmonella typhimurium is widely distributed and can cause disease in humans and certain animals. Other bacteria, such as Campylobacter jejuni, Yersinia, Aeromonas, Pseudomonas aeruginosa, Staphylococcus aureus, Shigella, Aerobacter, halophilic bacteria, etc., can also cause neonatal diarrhea.

　　2, Virus

　　轮状病毒是引起新生儿流行性腹泻的最常见病原之一，主要经粪口途径传播。健康成人可作为带毒者，已感染的新生儿也是重要感染原。轮状病毒在环境中较稳定，不易自然灭活，可通过护理人员传播。

　　Rotavirus is one of the most common pathogens causing neonatal epidemic diarrhea, mainly transmitted through the fecal-oral route. Healthy adults can act as carriers, and newborns who have been infected are also important sources of infection. Rotavirus is relatively stable in the environment and is not easily inactivated naturally, and can be transmitted by caregivers.

　　Three, fungi

　　Long-term use of antibiotics can lead to secondary fungal infections, with Candida albicans being more common.

　　Four, parasites

　　Common complications of neonatal epidemic diarrhea include diaper rash, thrush, urinary tract infection, otitis media, pneumonia, sepsis, necrotizing enterocolitis, malnutrition, malabsorption, hypokalemia, hypocalcemia, hypomagnesemia, multiple vitamin deficiencies (including vitamin K), anemia, etc.

　　The clinical symptoms of neonatal epidemic diarrhea mainly include the following aspects.

　　One, gastrointestinal symptoms

　　Children with diarrhea have diarrhea several times a day. Some children may have diarrhea 10 or more times. The character of stool is related to the pathogen and can be watery, mucous, or bloody. Children often have loss of appetite, abdominal distension, and vomiting.

　　Epidemic diarrhea in newborns caused by different pathogens has certain characteristics.

　　1, Escherichia coli enteritis: Children's stool is watery or egg-drop soup-like, with a foul smell. Enterotoxigenic Escherichia coli diarrhea stool is watery; invasive Escherichia coli diarrhea stool is mucus and purulent, with a foul smell, and the amount is not much.

　　2, Salmonella enterica enteritis: The stool can change in character, and can be watery, sticky and jelly-like, black-green or gray-white, with a distinct smell of putrefaction.

　　3, Rotavirus enteritis: Children may have an acute onset, often with fever, loose watery stool, a large amount, and the smell of putrefaction may not be obvious.

　　4, Staphylococcus aureus enteritis: Stool is mostly yellow-green, dark green, watery, with a foul smell.

　　5, fungal enteritis: Stool is yellow-green watery, or tofu-like, with a lot of foam.

　　Two, systemic symptoms

　　Children often have fever, malaise, crying and restlessness. Severe cases may have drowsiness, pale complexion, and cyanosis around the lips.

　　Three, water and electrolyte balance disorder

　　Neonatal diarrhea often occurs in a short period of time, causing complications such as dehydration, acidosis, hyponatremia, and hypokalemia. Severe cases may have gray complexion, cold limbs, decreased urine output, and shock.

　　Four, other

　　Some children may have other site infections at the same time, such as pneumonia, otitis media, urinary tract infection, thrush, sepsis, etc.

　　In terms of preventing neonatal epidemic diarrhea, the following points should be noted:

　　1. Do not take children to crowded public places. Avoid contact with sick children.

　　2. Pay attention to hygiene. Toys used by children and furniture that can be touched should be frequently washed with clean water. Wash your hands before eating. Parents should also wash their hands clean before feeding their children milk or food. Use running water to wash hands.

　　3. Do not eat cold and raw food. When eating cooked food, pay close attention to the production date and quality. It is best not to eat ready-to-eat food sold outside.

　　4. Prevent viral infection. Keep a balanced temperature and prevent colds.

　　The main examination methods for neonatal epidemic diarrhea are as follows:

　　1. When suspected of rotavirus enteritis, the early stool culture positivity rate is high, and stool smear electron microscopy or patient serum complement fixation test can be performed, or antibodies and antigens can be measured.

　　2. Neonatal diarrhea can lead to electrolyte metabolism or acid-base balance disorder, and blood gas, blood biochemistry, or electrocardiogram should be measured in a timely manner to observe for signs of hypokalemia, so as to detect and correct them in a timely manner.

　　Children with diarrhea should adjust their diet. For children who are adding complementary foods, they should stop adding complementary foods or reduce the frequency and amount of complementary foods. Infants should stop feeding food with high fat content. Infants with breast milk should try to breastfeed as much as possible. For children with nausea and vomiting, in addition to giving easily digestible food, attention should be paid to feeding water and food in small amounts and frequently, and slowly. When diarrhea and vomiting are particularly severe, the frequency of feeding can be reduced.

　　The main treatment methods for neonatal epidemic diarrhea are as follows:

　　1. Control infection

　　According to the pathogen and drug sensitivity results, antibiotics are selected. For Gram-negative bacilli, third-generation cephalosporin antibiotics or amoxicillin/clavulanate potassium (Anmeiting) can be used. Antibiotics are not needed for viral diarrhea. Fungal enteritis should discontinue the use of antibiotics and select nystatin.

　　2. Correct electrolyte and water imbalance

　　For neonatal diarrhea, it is necessary to observe at any time whether there is dehydration, acidosis, and electrolyte disorder, and to correct them in a timely manner. Neonates have great individual differences, and the amount of fluid replacement should also be individualized. For mild to moderate dehydration, the amount of fluid replacement should not be too much. For severe dehydration with circulatory failure, 20ml/kg of 2:1 isotonic fluid should be administered intravenously first. Neonatal diarrhea is prone to hyponatremia and hypokalemia.

　　3. Correct acidosis

　　Use sodium bicarbonate to correct acidosis. The goal of correcting acidosis is to keep the pH above 7.25.

　　4. Other treatments

　　Double octahedral montmorillonite (Smecta) can be used for treatment, 0.5g each time, 2-3 times a day. For those with long-lasting diarrhea, microecological regulators such as Bifidobacterium (Lizhu Intestine) should be used.