Risk of Bacterial Co- infections in Febrile Infants 60 Days Old and Younger with Documented Viral Infections

Maha­jan et al, J Pedi­atr. 2018 Dec

OBJECTIVE:

To deter­mine the risk of seri­ous bac­te­r­i­al infec­tions (SBIs) in young febrile infants with and with­out viral infec­tions.

RESULTS:

Of the 4778 enrolled infants, 2945 (61.6%) had viral test­ing per­formed, of whom 1200 (48.1%) were virus pos­i­tive; 44 of the 1200 had SBIs (3.7%; 95% CI, 2.7%-4.9%). Of the 1745 virus-neg­a­tive infants, 222 had SBIs (12.7%; 95% CI, 11.2%-14.4%). Rates of spe­cif­ic SBIs in the virus-pos­i­tive group vs the virus-neg­a­tive group were: UTIs (33 of 1200 [2.8%; 95% CI, 1.9%-3.8%] vs 186 of 1745 [10.7%; 95% CI, 9.2%-12.2%]) and bac­teremia (9 of 1199 [0.8%; 95% CI, 0.3%-1.4%] vs 50 of 1743 [2.9%; 95% CI, 2.1%-3.8%]). The rate of bac­te­r­i­al menin­gi­tis tend­ed to be low­er in the virus-pos­i­tive group (0.4%) than in the viral-neg­a­tive group (0.8%); the dif­fer­ence was not sta­tis­ti­cal­ly sig­nif­i­cant. Neg­a­tive viral sta­tus (aOR, 3.2; 95% CI, 2.3–4.6), was sig­nif­i­cant­ly asso­ci­at­ed with SBI in mul­ti­vari­able analy­sis.

CONCLUSIONS:

Febrile infants ≤60 days of age with viral infec­tions are at sig­nif­i­cant­ly low­er, but non-neg­li­gi­ble risk for SBIs, includ­ing bac­teremia and bac­te­r­i­al menin­gi­tis.

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