Masarweh Kamal, Bentur Lea, Bar-Yoseph Ronen, Kassis Imad, Dabaja-Younis Halima, Gur Michal
Pediatric Pulmonary Institute, CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa 3109601, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel.
J Clin Med. 2023 Jul 12;12(14):4636. doi: 10.3390/jcm12144636.
We aimed to evaluate the impact of respiratory symptoms and positive viral testing on the risk of serious bacterial infections (SBIs).
A retrospective study was conducted that included infants (0-60 days) presenting with a fever between 2001 and 2022 at a tertiary hospital in northern Israel. Demographic, clinical, and laboratory parameters were collected, and risk factors for SBIs were analyzed.
Data from a total of 3106 infants, including data from blood, urine, and CSF cultures, were obtained in 96.6%, 89%, and 29% of cases, respectively. A fever without respiratory symptoms (fever only) was present in 1312 infants, while 1794 had a fever and respiratory symptoms-427 were positive for a respiratory virus (virus+), 759 tested negative (virus-), and 608 were not tested. The SBI rate was 5.1% vs. 7.5% in the fever-and-respiratory group vs. the fever-only group ( = 0.004, OR = 0.65 (95% CI = 0.49-0.88)) and 2.8% vs. 7% in the virus+ vs. virus- group ( = 0.002, OR = 0.385, (95% CI = 0.203-0.728)). The male gender, an age < 1 month, leukocytosis > 15 × 10/L, or a CRP > 2 mg/dL increased the risk of SBIs. Respiratory symptoms or a confirmed viral infection reduced the risk of SBIs in the presence of the above risk factors.
Respiratory symptoms and a positive viral test decreased the risk of SBIs. Combining rapid viral testing with clinical variables may identify low-risk infants. Despite the relatively low risk of SBIs in individuals with viral infections, conducting prospective studies remains essential for accurately predicting the occurrence of these potentially life-threatening infections.
我们旨在评估呼吸道症状和病毒检测呈阳性对严重细菌感染（SBI）风险的影响。
进行了一项回顾性研究，纳入了2001年至2022年期间在以色列北部一家三级医院出现发热的婴儿（0至60天）。收集了人口统计学、临床和实验室参数，并分析了SBI的危险因素。
分别在96.6%、89%和29%的病例中获得了总共3106名婴儿的血液、尿液和脑脊液培养数据。1312名婴儿出现无呼吸道症状的发热（仅发热），而1794名婴儿有发热和呼吸道症状——427名呼吸道病毒检测呈阳性（病毒阳性），759名检测呈阴性（病毒阴性），608名未进行检测。发热伴呼吸道症状组的SBI发生率为5.1%，而仅发热组为7.5%（P = 0.004，OR = 0.65（95%CI = 0.49 - 0.88）），病毒阳性组为2.8%，病毒阴性组为7%（P = 0.002，OR = 0.385，（95%CI = 0.203 - 0.728））。男性、年龄小于1个月、白细胞增多>15×10⁹/L或CRP>2mg/dL会增加SBI的风险。在存在上述危险因素的情况下，呼吸道症状或确诊的病毒感染会降低SBI的风险。
呼吸道症状和病毒检测呈阳性会降低SBI的风险。将快速病毒检测与临床变量相结合可能识别出低风险婴儿。尽管病毒感染个体发生SBI的风险相对较低，但进行前瞻性研究对于准确预测这些潜在危及生命的感染的发生仍然至关重要。
