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Pediatrics. 2018 Feb;141(2). pii: e20172384. doi: 10.1542/peds.2017-2384. Epub 2018 Jan 17.

Rhinovirus in Febrile Infants and Risk of Bacterial Infection.

Author information

1
Departments of Pediatrics, anne.blaschke@hsc.utah.edu.
2
Departments of Pediatrics.
3
Pediatric Clinical Program, Intermountain Healthcare, Salt Lake City, Utah.
4
Internal Medicine, and.
5
Pathology, School of Medicine, University of Utah, Salt Lake City, Utah.
6
Patient Centered Microbiology Laboratory, Primary Children's Hospital, Intermountain Healthcare, Salt Lake City, Utah; and.
7
College of Medicine, Texas A&M Health Sciences Center, Bryan, Texas.

Abstract

BACKGROUND:

Febrile infants with viral respiratory infections have a reduced risk of bacterial infection compared with virus-negative infants. The risk of concomitant bacterial infection in febrile infants positive for human rhinovirus (HRV) by polymerase chain reaction (PCR) is unknown.

METHODS:

Infants 1-90 days old managed using the care process model for well-appearing febrile infants and with respiratory viral testing by PCR (RVPCR) in the emergency department or inpatient setting of 22 hospitals in the Intermountain Healthcare system from 2007-2016 were identified. Relative risk (RR) of bacterial infection was calculated for infants with HRV, non-HRV viruses, or no virus detected.

RESULTS:

Of 10 964 febrile infants identified, 4037 (37%) had RVPCR. Of these, 2212 (55%) were positive for a respiratory virus; 1392 (35%) for HRV alone. Bacterial infection was identified in 9.5%. Febrile infants with HRV detected were more likely to have bacterial infection than those with non-HRV viruses (7.8% vs 3.7%; P < .001; RR 2.12 [95% CI 1.43-3.15]). Risk of urinary tract infection was not significantly different for HRV-positive infants at any age, nor was risk of invasive bacterial infection (IBI; bacteremia and/or meningitis) meaningfully different for infants 1-28 day olds. Infants 29-90 days old with HRV had a decreased likelihood of IBI (RR 0.52 [95% CI 0.34-0.80]).

CONCLUSIONS:

HRV is common in febrile infants. Detection did not alter risk of concomitant urinary tract infection at any age or risk of IBI in infants 1-28 days old. HRV detection may be relevant in considering risk of IBI for infants 29-90 days of age.

PMID:
29343585
PMCID:
PMC5810600
DOI:
10.1542/peds.2017-2384
[Indexed for MEDLINE]
Free PMC Article

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