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Published on: April 4, 2019
Bacteraemia and antibiotic use in respiratory syncytial virus infections
P Bloomfield1, D Dalton, A Karleka
1Department of Immunology and Infectious Diseases, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia.
Insights
Bacteraemia is rare in children hospitalized with respiratory syncytial virus (RSV) infection. However, risk factors like nosocomial infection, congenital heart disease, or intensive care admission increase bacteraemia likelihood.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Viral Infections
- Bacteremia Research
Background:
- Respiratory syncytial virus (RSV) is a common cause of hospitalization in children.
- Bacteremia is a serious concern in hospitalized pediatric patients.
- Understanding risk factors for bacteremia in RSV infections is crucial for appropriate management.
Purpose of the Study:
- To determine the incidence of bacteremia in children hospitalized with RSV.
- To identify risk factors associated with bacteremia in this population.
- To assess current antibiotic usage patterns in hospitalized children with RSV.
Main Methods:
- Retrospective study of children aged 0-14 years admitted with proven RSV infection.
- Analysis of blood cultures to identify concurrent bacteremia.
- Examination of medical records for risk factors and antibiotic use.
Main Results:
- Bacteremia occurred in 0.6% of 1795 children with RSV infection.
- Higher bacteremia rates were observed in cases of nosocomial RSV (6.5%), cyanotic congenital heart disease (6.6%), and pediatric intensive care unit admission (2.9%).
- Antibiotics were administered to 45% of a randomly selected sample of RSV-infected children.
Conclusions:
- Bacteremia is infrequent in pediatric RSV infections.
- Nosocomial RSV, cyanotic congenital heart disease, and intensive care unit admission are significant risk factors for bacteremia.
- Current antibiotic prescribing practices warrant further investigation in this cohort.
Aims:
To examine the frequency of and risk factors for bacteraemia in children hospitalised with respiratory syncytial virus (RSV) infection; and to determine current use of antibiotics in hospitalised children with RSV infection.
Methods:
Retrospective study of all children, aged 0-14 years, admitted to a tertiary children's hospital with proven RSV infection over a four year period. Children with concurrent bacteraemia and RSV infection were identified, and risk factors examined for bacteraemia. The case notes of a randomly selected comparison sample of 100 of these RSV infected children were examined to assess antibiotic use and population incidence of risk factors for severe RSV infection.
Results:
A total of 1795 children had proven RSV infection, and blood cultures were sent on 861 (48%). Eleven (0.6%) of the 1795 RSV positive children had bacteraemia. RSV positive children had a significantly higher incidence of bacteraemia if they had nosocomial RSV infection (6.5%), cyanotic congenital heart disease (6.6%), or were admitted to the paediatric intensive care unit (2.9%). Forty five (45%) of the random comparison sample of RSV infected children received antibiotics.
Conclusions:
Bacteraemia is rare in RSV infection. Children with RSV infection are more likely to be bacteraemic, however, if they have nosocomial RSV infection, cyanotic congenital heart disease, or require intensive care unit admission.
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