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Cited by 246Neonatal and Maternal InfectionsPediatric Urology and Nephrology StudiesLiterature Analysis and Criticism

Serious Bacterial Infections in Febrile Infants 1 to 90 Days Old With and Without Viral Infections

Byington, Carrie L., Enriquez, F. Rene, Hoff, Charles, Tuohy, Richard, Taggart, E. William, Hillyard, David R., Carroll, Karen C., Christenson, John C.·2004·Pediatrics
DOI 10.1542/peds.113.6.1662
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Abstract

Objective. The risk of serious bacterial infection (SBI) in febrile infants who are classified as low risk (LR) or high risk (HR) by the Rochester criteria has been established. LR infants average a 1.4% occurrence of SBI, whereas HR infants have an occurrence of 21%. The occurrence of SBI in Rochester LR or HR infants with confirmed viral infections is unknown. The objective of this study was to determine the occurrence of SBI in Rochester LR and HR infants with and without viral infections. Methods. All febrile infants who were 90 days or younger and evaluated at Primary Children’s Medical Center between December 1996 and June 2002 were eligible. Infants were classified as Rochester LR or HR, and discharge diagnoses were collected. Viral testing for enteroviruses, respiratory viruses, rotavirus, and herpesvirus was performed as indicated by study protocol, clinical presentation, and season of the year. Results of all bacterial cultures were reviewed. Results. Of 1779 infants enrolled, 1385 (78%) had some form of viral diagnostic testing and 491 (35%) had 1 or more viruses identified. By the Rochester criteria, 456 (33%) infants were classified as LR and 922 (67%) infants as HR. For infants with viral infections, the occurrence of SBI was significantly lower than in infants without a viral infection (4.2% vs 12.3%). Rochester HR virus-positive (HR+) infants had significantly fewer bacterial infections than HR virus-negative (HR−) infants (5.5% vs 16.7%). When compared with HR− infants, HR+ infants were less likely to have bacteremia, urinary tract infection, or soft tissue infections, and HR+ infants had a similar occurrence of bacteremia as LR infants (0.92% vs 1.97%). Conclusions. Febrile infants with confirmed viral infections are at lower risk for SBI than those in whom a viral infection is not identified. Viral diagnostic data can positively contribute to the management of febrile infants, especially those who are classified as HR.

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Authors
Byington, C. L., Enriquez, F. R., Hoff, C., Tuohy, R., Taggart, E. W., Hillyard, D. R., Carroll, K. C., & Christenson, J. C.
Affiliations
  • University of Utah (US)
  • University of Minnesota (US)
  • Associated and Regional University Pathologists, Salt Lake City, Utah
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2004-06-01
Volume
113
Issue
6
Pages
1662-1666
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.113.6.1662
OpenAlex
W2024245559
Cited by
246
References
29
Citations by year
2026: 7 · 2025: 9 · 2024: 12 · 2023: 10 · 2022: 14 · 2021: 27 · 2020: 17 · 2019: 13 · 2018: 19 · 2017: 18 · 2016: 12 · 2015: 10 · 2014: 6 · 2013: 14 · 2012: 10
FWCI
2.69
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Center for Research Resources (M01RR000064)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Urology and Nephrology Studies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Literature Analysis and Criticism
Keywords
serious bacterial infection, febrile infants, viral infection, low-risk infants, high-risk infants, bacteremia, urinary tract infection, soft tissue infection, enterovirus, respiratory viruses, rotavirus, herpesvirus
MeSH terms
Bacterial Infections, Female, Fever, Humans, Infant, Infant, Newborn, Male, Risk Factors, Urinary Tract Infections, Virus Diseases, Bacteremia

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