In:
Hospital Pediatrics, American Academy of Pediatrics (AAP), Vol. 14, No. 8 ( 2024-08-01), p. 603-611
Abstract:
Viral bronchiolitis is a common pediatric illness. Treatment is supportive; however, some children have concurrent serious bacterial infections (cSBIs) requiring antibiotics. Identifying children with cSBI is challenging and may lead to unnecessary treatment. Improved understanding of the prevalence of and risk factors for cSBI are needed to guide treatment. We sought to determine the prevalence of cSBI and identify factors associated with cSBI in children hospitalized with bronchiolitis. METHODS We performed a retrospective cohort study of children & lt;2 years old hospitalized with bronchiolitis at a free-standing children’s hospital from 2012 to 2019 identified by International Classification of Diseases codes. cSBI was defined as bacteremia, urinary tract infection, meningitis, or pneumonia. Risk factors for cSBI were identified using logistic regression. RESULTS We identified 7871 admissions for bronchiolitis. At least 1 cSBI occurred in 4.2% of these admissions; with 3.5% meeting our bacterial pneumonia definition, 0.4% bacteremia, 0.3% urinary tract infection, and 0.02% meningitis. cSBI were more likely to occur in children with invasive mechanical ventilation (odds ratio [OR] 2.53, 95% confidence interval [CI] 1.78–3.63), a C-reactive protein ≥4 mg/dL (OR 2.20, 95% CI 1.47–3.32), a concurrent complex chronic condition (OR 1.67, 95% CI 1.22–2.25) or admission to the PICU (OR 1.46, 95% CI 1.02–2.07). CONCLUSIONS cSBI is uncommon among children hospitalized with bronchiolitis, with pneumonia being the most common cSBI. Invasive mechanical ventilation, elevated C-reactive protein, presence of complex chronic conditions, and PICU admission were associated with an increased risk of cSBI.
Type of Medium:
Online Resource
ISSN:
2154-1663
,
2154-1671
DOI:
10.1542/hpeds.2023-007549
Language:
English
Publisher:
American Academy of Pediatrics (AAP)
Publication Date:
2024
detail.hit.zdb_id:
2637594-1
