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Rate of invasive bacterial infection in recently vaccinated young infants with fever without source

Ana Barreiro-Parrado1, Eider Lopez1, Borja Gomez1,2

  • 1Pediatric Emergency Department, Hospital Universitario Cruces Urgencias de Pediatria, Barakaldo, Spain.

Archives of Disease in Childhood
|July 27, 2022
PubMed

Insights

Recent vaccinations in infants aged 42-90 days were associated with lower urinary tract infection rates. Invasive bacterial infection rates were similar, suggesting reconsidering routine blood tests for recently vaccinated, well-appearing infants.

Area of Science:

  • Pediatric Infectious Diseases
  • Vaccinology
  • Neonatal Care

Background:

  • Febrile infants aged 42-90 days are at risk for serious bacterial infections.
  • Vaccination status can influence the presentation and diagnosis of infections in infants.
  • Understanding infection rates in relation to recent immunizations is crucial for clinical management.

Purpose of the Study:

  • To compare the incidence of invasive bacterial infection (IBI) and urinary tract infection (UTI) in febrile infants (42-90 days).
  • To evaluate the impact of recent vaccination (within 48 hours) on IBI and UTI rates in this age group.

Main Methods:

  • Secondary analysis of a prospective registry-based cohort study.
  • Inclusion of 1522 febrile infants aged 42-90 days seen between 2010-2021.
  • Comparison of IBI and UTI rates between infants vaccinated and unvaccinated in the preceding 48 hours.

Main Results:

  • No invasive bacterial infections (IBI) were observed in recently vaccinated infants.
  • Urinary tract infection (UTI) rates were significantly lower in recently vaccinated infants (7.0% vs. 20.1%).
  • The odds ratio for UTI in unvaccinated infants was 3.3 compared to vaccinated infants.

Conclusions:

  • The lower UTI rate in recently vaccinated infants warrants consideration for UTI screening.
  • The absence of IBI in recently vaccinated infants may suggest a potential to reconsider routine blood tests in well-appearing infants.
  • Further confirmation is needed to refine diagnostic and management strategies for febrile infants based on vaccination status.
Abstract

Keywords:
Emergency CareInfectious Disease MedicinePaediatric Emergency Medicine

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