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Respiratory Viral Detection and Invasive Bacterial Infections in Infants ≤90 Days
Erin G Nicholson1,2, Tess Stopczynski3, Leila C Sahni1,2
1From the Baylor College of Medicine, Houston, TX.
The Pediatric Infectious Disease Journal
|August 10, 2026
Summary
Febrile infants 0 to 90 days old with specific respiratory viruses, like RSV, show a lower risk of invasive bacterial infections (IBIs). This finding aids in interpreting viral testing for infants with acute respiratory illness.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Neonatal Care
Background:
- Invasive bacterial infections (IBIs) are a concern in young infants.
- Accurate diagnosis requires understanding respiratory viral infections in infants 0-90 days old.
- Data are needed to guide molecular respiratory viral testing for IBI evaluation.
Purpose of the Study:
- To determine the frequency and severity of respiratory viral infections in infants 0-90 days old.
- To quantify the occurrence of IBI in febrile and nonfebrile infants with acute respiratory illness.
- To assess the relationship between respiratory viruses and IBI in this age group.
Main Methods:
- Cross-sectional analysis of infants 0-90 days old with emergency department visits or hospitalizations.
- Surveillance conducted at 7 US pediatric medical institutions.
- Respiratory viral detection and IBI assessment in relation to clinical severity.
Main Results:
- 3,780 infants were analyzed (December 2016-March 2020).
- Respiratory syncytial virus was the most common virus.
- IBIs were less frequent in infants with respiratory viruses (1.3%) compared to those without (4.9%).
- No IBIs detected with RSV, parainfluenza, metapneumovirus, influenza, or adenovirus alone.
Conclusions:
- Febrile infants 0-90 days old with certain respiratory viruses have a reduced risk of IBI.
- Findings support the interpretation of respiratory viral testing in this population.
- Further research can refine diagnostic and treatment strategies.