De Rose Domenico Umberto, Cortazzo Venere, Agosta Marilena, Bernaschi Paola, Ronchetti Maria Paola, Di Maio Velia Chiara, Di Pede Alessandra, Rechichi Jole, Braguglia Annabella, Perno Carlo Federico, Dotta Andrea
Neonatal Intensive Care Unit, "Bambino Gesù" Children's Hospital IRCCS, 00165 Rome, Italy.
PhD Course in Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Faculty of Medicine and Surgery, "Tor Vergata" University of Rome, 00133 Rome, Italy.
Antibiotics (Basel). 2024 Jul 26;13(8):702. doi: 10.3390/antibiotics13080702.
(1) Background: The literature reports a low risk of serious bacterial infections (SBIs) in febrile infants presenting with bronchiolitis or respiratory syncytial virus infection, but current microbiological techniques have a higher accuracy. (2) Methods: We assessed the risk of SBIs in neonates and infants with bronchiolitis from 2021 to 2023. We also evaluated C-reactive protein, procalcitonin, and leukocyte values. (3) Results: We included 242 infants. Blood cultures (BCs) were performed in 66/242 patients, with a positivity rate of 9.1% (including one BC with , considered as a contaminant). The cerebrospinal fluid culture was performed in 6/242 patients, and the results were all negative. Infection markers did not discriminate infants with positive BCs from those with negative ones. (4) Conclusions: Blood cultures should be performed in neonates and young infants with bronchiolitis fever, as the sepsis risk is not negligible. Conversely, our proposed algorithm is to wait for the respiratory panel results before decision-making for a lumbar puncture. Further studies are needed to understand lumbar puncture requirements.
(1) 背景：文献报道，患有细支气管炎或呼吸道合胞病毒感染的发热婴儿发生严重细菌感染（SBI）的风险较低，但目前的微生物学技术准确性更高。(2) 方法：我们评估了2021年至2023年患有细支气管炎的新生儿和婴儿发生SBI的风险。我们还评估了C反应蛋白、降钙素原和白细胞值。(3) 结果：我们纳入了242名婴儿。242名患者中有66名进行了血培养（BC），阳性率为9.1%（包括一份被视为污染物的BC）。242名患者中有6名进行了脑脊液培养，结果均为阴性。感染标志物无法区分血培养阳性和阴性的婴儿。(4) 结论：患有细支气管炎发热的新生儿和幼儿应进行血培养，因为败血症风险不可忽视。相反，我们提出的算法是在等待呼吸检测结果后再决定是否进行腰椎穿刺。需要进一步研究以了解腰椎穿刺的要求。
