Risk of Bacterial Infections in Febrile Infants 61 to 90 Days Old With Respiratory Viruses.

IF 6.2 2区医学 Q1 PEDIATRICS

Pediatrics Pub Date : 2025-06-13 DOI:10.1542/peds.2025-070617

Paul L Aronson, Prashant Mahajan, Blake Nielsen, Cody S Olsen, Huong D Meeks, Robert W Grundmeier, Nathan Kuppermann

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引用次数: 0

Abstract

Objective: The objective of this study was to describe the prevalence of urinary tract infections (UTIs), bacteremia, and bacterial meningitis among febrile infants aged 61 to 90 days with and without respiratory viral infections.

Methods: We used data from the Pediatric Emergency Care Applied Research Network (PECARN) Registry, comprised of pediatric visits from 17 emergency departments. Our cohort included infants aged 61 to 90 days with temperatures of at least 38°C, urinalyses/urine dipsticks and/or blood cultures, and respiratory viral testing performed between January 1, 2012, and April 30, 2024. We calculated the prevalence, with 95% CIs, of UTIs, bacteremia, and bacterial meningitis, stratified by presence and types of respiratory viral infections.

Results: We included 3678 visits; 1725 (46.9%) infants tested positive for respiratory viruses. Compared with viral-negative infants, respiratory viral-positive infants had a lower prevalence of UTIs (4.4% [95% CI 3.5-5.6%] vs 12.5% [95% CI 11.0-14.2%]) and bacteremia (1.0% [95% CI 0.5-1.8%] vs 3.0% [95% CI 2.1-4.1%]). No respiratory-viral positive infants had bacterial meningitis, whereas 4 viral-negative infants had meningitis. The prevalence of UTIs ranged from 2.2% to 5.2% in infants who tested positive for influenza, respiratory syncytial virus, or SARS-CoV-2, all lower than viral-negative infants. SARS-CoV-2 positive infants had a lower prevalence of bacteremia compared with SARS-CoV-2 negative infants (0.9% [95% CI 0.3-1.9%] vs 3.1% [95% CI 2.0-4.6%]).

Conclusions: The prevalence of bacterial infections is lower in respiratory virus-positive febrile infants aged 61 to 90 days. These findings may help inform use of respiratory viral testing in the evaluation for UTIs, bacteremia, and meningitis in this age group.

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61 ~ 90日龄发热婴儿呼吸道病毒细菌感染的风险

目的：本研究的目的是描述尿路感染（uti）、菌血症和细菌性脑膜炎在61至90天发热婴儿中有无呼吸道病毒感染的患病率。方法：我们使用来自儿科急诊应用研究网络（PECARN）注册的数据，包括来自17个急诊科的儿科就诊。我们的队列包括在2012年1月1日至2024年4月30日期间进行的61至90天的婴儿，体温至少为38°C，进行尿液分析/尿试纸和/或血液培养，并进行呼吸道病毒检测。我们计算了尿路感染、菌血症和细菌性脑膜炎的患病率（95% ci），并按呼吸道病毒感染的存在和类型分层。结果：我们纳入了3678次就诊；1725名（46.9%）婴儿呼吸道病毒检测呈阳性。与病毒阴性婴儿相比，呼吸道病毒阳性婴儿的uti患病率较低（4.4% [95% CI 3.5-5.6%] vs 12.5% [95% CI 11.0-14.2%]），菌血症患病率较低（1.0% [95% CI 0.5-1.8%] vs 3.0% [95% CI 2.1-4.1%]）。没有呼吸道病毒阳性的婴儿患有细菌性脑膜炎，而4名病毒阴性的婴儿患有脑膜炎。在流感、呼吸道合胞病毒或SARS-CoV-2检测呈阳性的婴儿中，尿路感染的患病率为2.2%至5.2%，均低于病毒阴性的婴儿。与SARS-CoV-2阴性婴儿相比，SARS-CoV-2阳性婴儿的菌血症患病率较低（0.9% [95% CI 0.3-1.9%] vs 3.1% [95% CI 2.0-4.6%]）。结论：61 ~ 90天呼吸道病毒阳性发热婴儿细菌感染发生率较低。这些发现可能有助于在评估该年龄组的尿路感染、菌血症和脑膜炎时使用呼吸道病毒检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatrics 医学-小儿科

CiteScore

12.80

自引率

5.00%

发文量

791

审稿时长

2-3 weeks

期刊介绍： The Pediatrics® journal is the official flagship journal of the American Academy of Pediatrics (AAP). It is widely cited in the field of pediatric medicine and is recognized as the leading journal in the field. The journal publishes original research and evidence-based articles, which provide authoritative information to help readers stay up-to-date with the latest developments in pediatric medicine. The content is peer-reviewed and undergoes rigorous evaluation to ensure its quality and reliability. Pediatrics also serves as a valuable resource for conducting new research studies and supporting education and training activities in the field of pediatrics. It aims to enhance the quality of pediatric outpatient and inpatient care by disseminating valuable knowledge and insights. As of 2023, Pediatrics has an impressive Journal Impact Factor (IF) Score of 8.0. The IF is a measure of a journal's influence and importance in the scientific community, with higher scores indicating a greater impact. This score reflects the significance and reach of the research published in Pediatrics, further establishing its prominence in the field of pediatric medicine.