Serious bacterial infections in infants younger than 90 days of age with acute bronchiolitis.

IF 2.6 3区医学 Q1 PEDIATRICS

European Journal of Pediatrics Pub Date : 2025-07-22 DOI:10.1007/s00431-025-06340-0

Minsung Kim, Jin Lee, Seung Beom Han, Soo Young Lee

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引用次数: 0

Abstract

Although acute bronchiolitis is primarily caused by viral infections, antibiotics are often administered to children with acute bronchiolitis. Due to concerns about serious bacterial infections (SBI), neonates and young infants are particularly prone to antibiotic overuse. This study aimed to identify the clinical characteristics and prevalence of SBI in neonates and infants aged < 90 days with acute bronchiolitis. We retrospectively reviewed the medical records of 651 neonates and infants aged < 90 days hospitalized with acute bronchiolitis between September 2015 and August 2024. Demographic and clinical data were analyzed to assess their clinical characteristics and the prevalence of SBI. Of the 651 infants, 230 (35.3%) had fever, and 485 (74.5%) received antibiotics. Blood cultures were performed in 646 (99.2%) infants; 52 (8.0%) yielded bacterial growth, but 50 were skin contaminants and one (Enterococcus faecium from an afebrile infant) was considered clinically insignificant. Only one (0.2%) infant had a probable true bacteremia caused by methicillin-susceptible Staphylococcus aureus. Among 621 (95.4%) infants who underwent urine cultures, seven (1.1%) had both bacteriuria and pyuria. Among them, only one (0.2%) infant had fever, which was deemed to have clinically significant urinary tract infection. Cerebrospinal fluid cultures in 31 infants were all negative.

Conclusion: SBI were rare in neonates and infants aged < 90 days hospitalized for acute bronchiolitis. This suggests that routine sepsis workups and empirical antibiotic therapy are not necessary for most of these patients. A selective approach to bacterial testing and antibiotic therapy is strongly justified.

What is known: •Empirical antibiotics are commonly used in infants aged ‹90 days with acute bronchiolitis due to concerns about concurrent serious bacterial infections.

What is new: •Serious bacterial infections are extremely rare in infants aged ‹90 days hospitalized with acute bronchiolitis, regardless of fever.

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年龄小于90天的急性细支气管炎婴儿的严重细菌感染

虽然急性细支气管炎主要是由病毒感染引起的，但急性细支气管炎儿童经常使用抗生素。由于对严重细菌感染（SBI）的担忧，新生儿和幼儿特别容易过度使用抗生素。本研究旨在确定新生儿和老年婴儿SBI的临床特征和患病率。结论：新生儿和老年婴儿SBI罕见。了解情况：•由于担心并发严重细菌感染，经验抗生素通常用于90天的急性细支气管炎婴儿。新发现：•急性细支气管炎住院90天的婴儿中，严重的细菌感染极为罕见，无论是否发烧。

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

European Journal of Pediatrics 医学-小儿科

CiteScore

5.90

自引率

2.80%

发文量

367

审稿时长

3-6 weeks

期刊介绍： The European Journal of Pediatrics (EJPE) is a leading peer-reviewed medical journal which covers the entire field of pediatrics. The editors encourage authors to submit original articles, reviews, short communications, and correspondence on all relevant themes and topics. EJPE is particularly committed to the publication of articles on important new clinical research that will have an immediate impact on clinical pediatric practice. The editorial office very much welcomes ideas for publications, whether individual articles or article series, that fit this goal and is always willing to address inquiries from authors regarding potential submissions. Invited review articles on clinical pediatrics that provide comprehensive coverage of a subject of importance are also regularly commissioned. The short publication time reflects both the commitment of the editors and publishers and their passion for new developments in the field of pediatrics. EJPE is active on social media (@EurJPediatrics) and we invite you to participate. EJPE is the official journal of the European Academy of Paediatrics (EAP) and publishes guidelines and statements in cooperation with the EAP.