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Bacteremia in Children Hospitalized with Respiratory Syncytial Virus Infection

Miriam Cebey-López1,2, Jacobo Pardo-Seco1,2,3, Alberto Gómez-Carballa1,2,3

  • 1Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP - www.genvip.org), Hospital Clínico Universitario and Universidade de Santiago de Compostela (USC), Galicia, Spain.

Plos One
|February 13, 2016
PubMed

Insights

Bacteremia is uncommon in infants hospitalized with RSV respiratory infections. However, it is more prevalent in severe cases requiring intensive care and respiratory support.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • The incidence of bacteremia in children with acute bronchiolitis is generally considered low.
  • The precise rate of occult bacteremia in infants diagnosed with respiratory syncytial virus (RSV) infection remains unclear.
  • This study aimed to establish the prevalence and identify predictive factors for bacteremia in hospitalized children with confirmed RSV acute respiratory illness (ARI).

Purpose of the Study:

  • To determine the actual rate of bacteremia in infants hospitalized with RSV-associated acute respiratory illness (ARI).
  • To identify potential predictive factors associated with bacteremia in this pediatric population.
  • To compare the incidence of bacteremia using both conventional blood cultures and advanced molecular diagnostic techniques.

Main Methods:

  • A prospective, multicenter study was conducted between 2011 and 2013, enrolling children under two years old admitted for ARI.
  • Blood samples from RSV-positive patients were analyzed for bacterial presence using polymerase chain reaction (PCR) for common pathogens, alongside traditional culture methods.
  • Specific bacteria targeted by PCR included: *Neisseria meningitidis*, *Streptococcus pneumoniae*, *Haemophilus influenzae*, *Streptococcus pyogenes*, *Klebsiella pneumoniae*, *Pseudomonas aeruginosa*, *Escherichia coli*, and *Staphylococcus aureus*.

Main Results:

  • Out of 66 children with RSV-positive ARI, bacterial presence was detected in 10.6% (7 children).
  • The identified bacteria were *Haemophilus influenzae* (n=4) and *Streptococcus pneumoniae* (n=2).
  • Children with detected bacteremia showed significantly higher severity scores, including PICU admission (100% vs. 50%), need for respiratory support (100% vs. 18.6%), and longer hospitalization (12.1 vs. 7.5 days).

Conclusions:

  • Bacteremia is infrequent in infants hospitalized for RSV respiratory infections.
  • However, the possibility of bacteremia should be seriously considered in infants presenting with severe RSV illness.
  • The findings highlight the importance of considering bacterial coinfection in severe pediatric respiratory infections.
Abstract

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