Kim Suji, Moon Hye Min, Lee Joon Kee, Rhie Kyuyol, Yoon Ki Wook, Choi Eun Hwa, Lee Hoan Jong, Lee Hyunju
Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
Pediatr Int. 2017 Dec;59(12):1240-1245. doi: 10.1111/ped.13428.
Infants aged <90 days who present with fever commonly undergo various invasive procedures due to the risk of bacterial infection in this age group. A great proportion of cases, however, are due to viral infection, including influenza. The aim of this study was therefore to assess the impact of influenza testing in infants <90 days with fever, as well as analyze the subject characteristics to identify which infants should be considered for such testing.
Clinical characteristics and trends in influenza virus testing and treatment were analyzed among febrile infants <90 days who presented to the emergency room and were diagnosed with influenza during 2005-2015.
Among 5,347 febrile infants aged <90 days, 963 (18%) underwent influenza virus test. A total of 114 (11.8%) were diagnosed with influenza. The positivity rate reached 67% of febrile infants during epidemics. Of them, 83 had a history of family contact. While more than half presented with upper respiratory symptoms, 34% had only fever without respiratory symptoms. A decrease in antibiotic use and admission rates during the study period among infants diagnosed with influenza was seen (P for trend <0.05).
During the influenza epidemic season, diagnostic tests for influenza based on a detailed contact history are necessary in assessing the cause of fever. Targeted testing for influenza may lead to a decrease in antibiotic use and admission rates in young infants.
90日龄以下的发热婴儿由于该年龄组存在细菌感染风险，通常需要接受各种侵入性检查。然而，很大一部分病例是由病毒感染引起的，包括流感。因此，本研究的目的是评估流感检测对90日龄以下发热婴儿的影响，并分析受试者特征，以确定哪些婴儿应考虑进行此类检测。
对2005年至2015年期间到急诊室就诊并被诊断为流感的90日龄以下发热婴儿的临床特征以及流感病毒检测和治疗趋势进行分析。
在5347名90日龄以下的发热婴儿中，963名（18%）接受了流感病毒检测。共有114名（11.8%）被诊断为流感。在流行期间，发热婴儿的阳性率达到67%。其中，83名有家庭接触史。虽然超过一半的患儿出现上呼吸道症状，但34%的患儿仅有发热而无呼吸道症状。在研究期间，诊断为流感的婴儿抗生素使用和住院率有所下降（趋势P<0.05）。
在流感流行季节，基于详细接触史进行流感诊断检测对于评估发热原因是必要的。针对性的流感检测可能会降低幼儿的抗生素使用和住院率。
