tetano
Editor, Senior Moderator
Pediatr Infect Dis J. 2018 Aug 30. doi: 10.1097/INF.0000000000002165. [Epub ahead of print]
[h=1]The Risk of Serious Bacterial Infection in Febrile Infants 0-90 Days of Life with a Respiratory Viral Infection.[/h] Nicholson EG[SUP]1,[/SUP][SUP]2[/SUP], Avadhanula V[SUP]2[/SUP], Ferlic-Stark L[SUP]2[/SUP], Patel K[SUP]2[/SUP], Gincoo KE[SUP]2[/SUP], Piedra PA[SUP]1,[/SUP][SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Molecular diagnostic methods enhance the sensitivity and broaden the spectrum of detectable respiratory viruses in febrile infants ≤90 days of life. We describe the occurrence of respiratory viruses in this population as well as the rates of serious bacterial infection (SBI) and respiratory viral co-infection with regard to viral characteristics.
[h=4]METHODS:[/h] This was a prospective observational cohort study performed in the emergency department that included previously healthy febrile infants ≤90 days of life. Clinical and historical characteristics were documented and a respiratory nasal wash specimen was obtained from each patient. This sample was tested for 17 common respiratory pathogens and a chart review was conducted to ascertain if the infant was diagnosed with an SBI.
[h=4]RESULTS:[/h] In a 12-month period, 67% of the 104 recruited febrile infants were positive for a respiratory virus. The most commonly detected viruses were rhinovirus, respiratory syncytial virus, enterovirus and influenza. The rate of respiratory viral and SBI co-infection was 9% overall and infants with either a systemic respiratory virus or negative viral testing were 3 times more likely to have an SBI than those with viruses typically restricted to the respiratory mucosa (95% CI: 1.1, 9.7).
[h=4]CONCLUSIONS:[/h] Respiratory viruses are readily detectable via nasopharyngeal wash in febrile infants ≤90 days of life. With the enhanced sensitivity of molecular respiratory diagnostics, rates of co-infection of respiratory viruses and SBI may be higher than previously thought. Further investigation utilizing molecular diagnostics is needed to guide usage in febrile infants ≤90 days.
PMID: 30169487 DOI: 10.1097/INF.0000000000002165
[h=1]The Risk of Serious Bacterial Infection in Febrile Infants 0-90 Days of Life with a Respiratory Viral Infection.[/h] Nicholson EG[SUP]1,[/SUP][SUP]2[/SUP], Avadhanula V[SUP]2[/SUP], Ferlic-Stark L[SUP]2[/SUP], Patel K[SUP]2[/SUP], Gincoo KE[SUP]2[/SUP], Piedra PA[SUP]1,[/SUP][SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Molecular diagnostic methods enhance the sensitivity and broaden the spectrum of detectable respiratory viruses in febrile infants ≤90 days of life. We describe the occurrence of respiratory viruses in this population as well as the rates of serious bacterial infection (SBI) and respiratory viral co-infection with regard to viral characteristics.
[h=4]METHODS:[/h] This was a prospective observational cohort study performed in the emergency department that included previously healthy febrile infants ≤90 days of life. Clinical and historical characteristics were documented and a respiratory nasal wash specimen was obtained from each patient. This sample was tested for 17 common respiratory pathogens and a chart review was conducted to ascertain if the infant was diagnosed with an SBI.
[h=4]RESULTS:[/h] In a 12-month period, 67% of the 104 recruited febrile infants were positive for a respiratory virus. The most commonly detected viruses were rhinovirus, respiratory syncytial virus, enterovirus and influenza. The rate of respiratory viral and SBI co-infection was 9% overall and infants with either a systemic respiratory virus or negative viral testing were 3 times more likely to have an SBI than those with viruses typically restricted to the respiratory mucosa (95% CI: 1.1, 9.7).
[h=4]CONCLUSIONS:[/h] Respiratory viruses are readily detectable via nasopharyngeal wash in febrile infants ≤90 days of life. With the enhanced sensitivity of molecular respiratory diagnostics, rates of co-infection of respiratory viruses and SBI may be higher than previously thought. Further investigation utilizing molecular diagnostics is needed to guide usage in febrile infants ≤90 days.
PMID: 30169487 DOI: 10.1097/INF.0000000000002165