Pediatric Infectious Diseases, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Strasse, Building 43, 66421, Homburg, Germany.
BMC Infect Dis. 2020 Aug 17;20(1):606. doi: 10.1186/s12879-020-05336-5.
Infections due to Respiratory Syncytial Virus (RSV) and Influenza virus (FLU) are leading causes of hospitalization in young children. Yet, there is little data on factors associated with antibiotic use in these patients.
We conducted a retrospective, single-center study of all patients below 2 years of age hospitalized between 2014 and 2018. We compared children with RSV infection to children with FLU infection analyzing clinical characteristics and factors contributing to an increased rate of antimicrobial utilization.
RSV infection was diagnosed in 476/573 (83.1%), FLU in 95/573 (16.6%), and RSV-FLU-co-infection in 2/573 (0.3%) patients. Median age was lower for RSV compared to FLU (4 vs. 12 months; p < 0.0001). Children with RSV had longer hospitalization (5 vs. 4 days; p = 0.0023) and needed oxygen more frequently (314/476 vs. 23/95; p < 0.0001) than FLU patients. There was no significant difference in the overall antibiotic utilization between RSV and FLU patients (136/476 vs. 21/95; p = 0.2107). Logistic regression analyses revealed that septic appearance on admission (odds ratio [OR] 8.95, 95% confidence interval [CI] 1.5-54.1), acute otitis media (OR 4.5, 95% CI 2.1-9.4), a longer oxygen therapy (OR 1.40; 95% CI 1.13-1.74) and a higher C-reactive protein (CRP) (OR 1.7, 95% CI 1.5-2.0) were significantly associated with antibiotic use in both groups, but not age or pneumonia.
In our cohort, the rate of antibiotic utilization was comparable between RSV and FLU patients, while for both groups distinct clinical presentation and a high CRP value were associated with higher antibiotic use.
呼吸道合胞病毒（RSV）和流感病毒（FLU）感染是导致幼儿住院的主要原因。然而，关于这些患者使用抗生素的相关因素的数据很少。
我们对 2014 年至 2018 年间住院的所有 2 岁以下患者进行了回顾性单中心研究。我们将 RSV 感染患儿与 FLU 感染患儿进行比较，分析了导致抗菌药物使用率增加的临床特征和因素。
在 573 例患者中，诊断为 RSV 感染的有 476 例（83.1%），FLU 感染的有 95 例（16.6%），RSV-FLU 合并感染的有 2 例（0.3%）。与 FLU 相比，RSV 感染患儿的中位年龄更低（4 个月 vs. 12 个月；p<0.0001）。RSV 患儿的住院时间更长（5 天 vs. 4 天；p=0.0023），需要吸氧的频率更高（314/476 例 vs. 23/95 例；p<0.0001）。RSV 和 FLU 患儿的总体抗生素使用率无显著差异（136/476 例 vs. 21/95 例；p=0.2107）。Logistic 回归分析显示，入院时表现为败血症（优势比 [OR] 8.95，95%置信区间 [CI] 1.5-54.1）、急性中耳炎（OR 4.5，95%CI 2.1-9.4）、较长时间的氧疗（OR 1.40；95%CI 1.13-1.74）和较高的 C 反应蛋白（CRP）（OR 1.7，95%CI 1.5-2.0）与两组患者的抗生素使用显著相关，但与年龄或肺炎无关。
在我们的队列中，RSV 和 FLU 患者的抗生素使用率相当，而对于两组患者，不同的临床表现和较高的 CRP 值与更高的抗生素使用率相关。
