Prevalence of and Risks for Bacterial Infections in Hospitalized Children With Bronchiolitis.

Area of Science:

• Pediatrics
• Infectious Diseases
• Critical Care Medicine

Background:

• Viral bronchiolitis is a frequent pediatric hospitalization diagnosis.
• Concurrent serious bacterial infections (cSBIs) are possible but challenging to identify.
• Accurate identification of cSBI is crucial to guide appropriate antibiotic use.

Purpose of the Study:

• To determine the prevalence of cSBI in hospitalized pediatric bronchiolitis cases.
• To identify risk factors associated with cSBI in this population.

Main Methods:

• Retrospective cohort study of children under 2 years old hospitalized with bronchiolitis (2012-2019).
• cSBI defined as bacteremia, urinary tract infection, meningitis, or pneumonia.
• Logistic regression used to identify risk factors.

Main Results:

• 7871 admissions identified; 4.2% had at least one cSBI.
• Bacterial pneumonia was the most common cSBI (3.5%).
• Increased risk of cSBI associated with invasive mechanical ventilation, elevated C-reactive protein (≥4 mg/dL), complex chronic conditions, and PICU admission.

Conclusions:

• cSBIs are infrequent in pediatric bronchiolitis hospitalizations.
• Pneumonia is the most prevalent cSBI.
• Specific factors like mechanical ventilation and PICU admission indicate higher cSBI risk.