Giuseppe
Emeritus
Pediatrics. 2009 Jul;124(1):30-9.
Influenza virus infection and the risk of serious bacterial infections in young febrile infants.
Krief WI, Levine DA, Platt SL, Macias CG, Dayan PS, Zorc JJ, Feffermann N, Kuppermann N;
Multicenter RSV-SBI Study Group of the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. Department of Pediatrics and Emergency Medicine, Schneider Children's Hospital/Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA. wkrief@NSHS.edu
OBJECTIVE:
We aimed to determine the risk of SBIs in febrile infants with influenza virus infections and compare this risk with that of febrile infants without influenza infections.
PATIENTS AND METHODS:
We conducted a multicenter, prospective, cross-sectional study during 3 consecutive influenza seasons. All febrile infants <or=60 days="" age="" at="" any="" 5="" participating="" pediatric="" eds="" between="" october="" march="" 1998="" through="" 2001="" were="" eligible.="" determined="" influenza="" virus="" status="" rapid="" antigen="" detection.="" we="" evaluated="" infants="" with="" blood,="" urine,="" cerebrospinal="" fluid,="" and="" stool="" cultures.="" urinary="" tract="" infection="" (uti)="" was="" defined="" by="" single-pathogen="" growth="" of="" either="">or=5 x 10(4) colony-forming units per mL or >or=10(4) colony-forming units per mL in association with a positive urinalysis. Bacteremia, bacterial meningitis, and bacterial enteritis were defined by growth of a known bacterial pathogen. SBI was defined as any of the 4 above-mentioned bacterial infections.
RESULTS:
During the 3-year study period, 1091 infants were enrolled. A total of 844 (77.4%) infants were tested for the influenza virus, of whom 123 (14.3%) tested positive. SBI status was determined in 809 (95.9%) of the 844 infants. Overall, 95 (11.7%) of the 809 infants tested for influenza virus had an SBI. Infants with influenza infections had a significantly lower prevalence of SBI (2.5%) and UTI (2.4%) when compared with infants who tested negative for the influenza virus. Although there were no cases of bacteremia, meningitis, or enteritis in the influenza-positive group, the differences between the 2 groups for these individual infections were not statistically significant.
CONCLUSIONS:
Febrile infants <or=60 days of age with influenza infections are at significantly lower risk of SBIs than febrile infants who are influenza-negative. Nevertheless, the rate of UTI remains appreciable in febrile, influenza-positive infants.
PMID: 19564280 [PubMed - in process]
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Influenza virus infection and the risk of serious bacterial infections in young febrile infants.
Krief WI, Levine DA, Platt SL, Macias CG, Dayan PS, Zorc JJ, Feffermann N, Kuppermann N;
Multicenter RSV-SBI Study Group of the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. Department of Pediatrics and Emergency Medicine, Schneider Children's Hospital/Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA. wkrief@NSHS.edu
OBJECTIVE:
We aimed to determine the risk of SBIs in febrile infants with influenza virus infections and compare this risk with that of febrile infants without influenza infections.
PATIENTS AND METHODS:
We conducted a multicenter, prospective, cross-sectional study during 3 consecutive influenza seasons. All febrile infants <or=60 days="" age="" at="" any="" 5="" participating="" pediatric="" eds="" between="" october="" march="" 1998="" through="" 2001="" were="" eligible.="" determined="" influenza="" virus="" status="" rapid="" antigen="" detection.="" we="" evaluated="" infants="" with="" blood,="" urine,="" cerebrospinal="" fluid,="" and="" stool="" cultures.="" urinary="" tract="" infection="" (uti)="" was="" defined="" by="" single-pathogen="" growth="" of="" either="">or=5 x 10(4) colony-forming units per mL or >or=10(4) colony-forming units per mL in association with a positive urinalysis. Bacteremia, bacterial meningitis, and bacterial enteritis were defined by growth of a known bacterial pathogen. SBI was defined as any of the 4 above-mentioned bacterial infections.
RESULTS:
During the 3-year study period, 1091 infants were enrolled. A total of 844 (77.4%) infants were tested for the influenza virus, of whom 123 (14.3%) tested positive. SBI status was determined in 809 (95.9%) of the 844 infants. Overall, 95 (11.7%) of the 809 infants tested for influenza virus had an SBI. Infants with influenza infections had a significantly lower prevalence of SBI (2.5%) and UTI (2.4%) when compared with infants who tested negative for the influenza virus. Although there were no cases of bacteremia, meningitis, or enteritis in the influenza-positive group, the differences between the 2 groups for these individual infections were not statistically significant.
CONCLUSIONS:
Febrile infants <or=60 days of age with influenza infections are at significantly lower risk of SBIs than febrile infants who are influenza-negative. Nevertheless, the rate of UTI remains appreciable in febrile, influenza-positive infants.
PMID: 19564280 [PubMed - in process]
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