Febrile Young Infants Less than 120 Days Old in the Post-COVID-19 Pandemic Era: Sterile Pyuria or Urinary Tract...

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• The Coronavirus Disease 2019 (COVID-19) pandemic has led to an increase in febrile young infants presenting with concurrent COVID-19 infections.
• Urinary tract infection (UTI) is a significant cause of severe bacterial infections in young infants.
• Data on pyuria and UTI incidence in febrile infants with or without COVID-19 post-pandemic is limited.

Purpose of the Study:

• To investigate the incidence of pyuria and UTI in febrile young infants.
• To compare UTI rates in infants with and without COVID-19.
• To inform antibiotic prescribing practices for febrile infants during the COVID-19 era.

Main Methods:

• Retrospective analysis of clinical and laboratory data.
• Inclusion of febrile infants (<120 days old) admitted to a tertiary hospital from March 2023 to February 2024.
• COVID-19 testing performed during emergency department visits or hospitalization.

Main Results:

• Out of 265 infants, 124 (46.8%) tested positive for COVID-19.
• Infants with COVID-19 had significantly lower UTI incidence (8.1%) compared to those without (33.3%).
• Sterile pyuria incidence was higher in COVID-19 positive infants (36.3%) versus negative (23.4%).

Conclusions:

• Febrile infants with COVID-19 exhibit high pyuria but low UTI rates.
• Routine empirical antibiotics may not be necessary for febrile infants with COVID-19.
• Emphasizes the need for judicious antibiotic use in this pediatric population.