Abstract: Background:Enterovirus (EV) is one of the common pathogens that cause neonatal infection. Understanding the positive rate of EV nucleic acid detection and the disease distribution of hospitalized newborns will facilitate the development of rational therapeutic strategies. Objective:To investigate the positive rate of enterovirus nucleic acid swabs in hospitalized neonates and its distribution in diseases. Design:A crosssectional study. Methods:For patients hospitalized in neonatal medical ward at Beijing Children′s Hospital from October 1, 2020 to September 30, 2021,the throat swabs were taken on the day of admission. Realtime PCR was used to detected general enterovirus (EV)EV71/CA16(Coxsackievirus A16). The positive rate of EV nucleic acid test and its distribution in disease was calculated. Clinical manifestations and laboratory tests between the EV positive group and the negative group were compared. Main outcome measures:Positive rate of EV nucleic acid detection and disease distribution in hospitalized neonates. Results:A total of 1,095 neonates (accounting for 91.2% of the hospitalized patients during the same period) were enrolled, including 605 males (55.3%) and 976 term infants (89.1%). The median age of admission was 11 (419) days and the median hospital stay was 8 (612) days. The first three orders of admission diagnosis were neonatal hyperbilirubinemia, neonatal pneumonia, and neonatal septicemia. The positive rate of EV nucleic acid test was 9.1‰ (10/1095). The positive rate of EV nucleic acid in infectious diseases was (9/483, 18.6‰). Among them, 5 cases (50%), 3 cases (30%) and 2 cases (20%) were presented with respiratory symptoms, jaundice and gastrointestinal symptoms as the first symptoms, respectively. Ten children were cured or improved and discharged. There were no statistically significant differences between children with positive and negative EV nucleic acid tests in gender, birth weight, gestational age, preterm delivery, delivery mode, feeding mode, maternal risk factors of perinatal infection, maternal gestational diabetes, age of onset, length of hospital stay and hospitalization cost (P>0.05). The incidence of contact with family members with symptomatic infection before onset was 60% in children with positive EV nucleic acid test, higher than 7% in children with negative EV test, and the difference was statistically significant (P<0.001). The proportion of central nervous system infection in children with positive and negative EV nucleic acid test was 20% and 3.1%, respectively, and the difference was statistically significant (P<0.05), but there was no significant difference in the incidence of fever, pathological jaundice, respiratory symptoms, digestive symptoms and nervous system symptoms (P>0.05). The proportion of children with infectious disease was 90% in EV positive children, higher than 43.7% in EV negative children, but there was no statistical significance. There was no statistical significance in the total number of white blood cells, incidence of hemoglobin, thrombocytopenia, incidence of myocardial enzyme and glutamicpyruvic transaminase, serum total bilirubin value, albumin, serum creatinine and blood urea nitrogen in the positive and negative children with EV nucleic acid test (P>0.05). Conclusions:The positive rate of nucleic acid test of EV throat swabs was 9.1‰ at admission, and there was no specific change in clinical manifestations and laboratory routine test results. Transmission from family members may be the main cause of positive EV nucleic acid test in neonates. Children with positive EV nucleic acid test have a higher risk of central nervous system infection.

Key words: Enterovirus infection, Clinical features, Infant