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Abstract：
OBJECTIVE: We aimed to evaluate the impact of respiratory symptoms and positive viral testing on the risk of serious bacterial infections (SBIs).
METHODS: A retrospective study was conducted that included infants (0-60 days) presenting with a fever between 2001 and 2022 at a tertiary hospital in northern Israel. Demographic, clinical, and laboratory parameters were collected, and risk factors for SBIs were analyzed.
RESULTS: Data from a total of 3106 infants, including data from blood, urine, and CSF cultures, were obtained in 96.6%, 89%, and 29% of cases, respectively. A fever without respiratory symptoms (fever only) was present in 1312 infants, while 1794 had a fever and respiratory symptoms-427 were positive for a respiratory virus (virus+), 759 tested negative (virus-), and 608 were not tested. The SBI rate was 5.1% vs. 7.5% in the fever-and-respiratory group vs. the fever-only group (p = 0.004, OR = 0.65 (95% CI = 0.49-0.88)) and 2.8% vs. 7% in the virus+ vs. virus- group (p = 0.002, OR = 0.385, (95% CI = 0.203-0.728)). The male gender, an age < 1 month, leukocytosis > 15 × 109/L, or a CRP > 2 mg/dL increased the risk of SBIs. Respiratory symptoms or a confirmed viral infection reduced the risk of SBIs in the presence of the above risk factors.
CONCLUSIONS: Respiratory symptoms and a positive viral test decreased the risk of SBIs. Combining rapid viral testing with clinical variables may identify low-risk infants. Despite the relatively low risk of SBIs in individuals with viral infections, conducting prospective studies remains essential for accurately predicting the occurrence of these potentially life-threatening infections.
METHODS: A retrospective study was conducted that included infants (0-60 days) presenting with a fever between 2001 and 2022 at a tertiary hospital in northern Israel. Demographic, clinical, and laboratory parameters were collected, and risk factors for SBIs were analyzed.
RESULTS: Data from a total of 3106 infants, including data from blood, urine, and CSF cultures, were obtained in 96.6%, 89%, and 29% of cases, respectively. A fever without respiratory symptoms (fever only) was present in 1312 infants, while 1794 had a fever and respiratory symptoms-427 were positive for a respiratory virus (virus+), 759 tested negative (virus-), and 608 were not tested. The SBI rate was 5.1% vs. 7.5% in the fever-and-respiratory group vs. the fever-only group (p = 0.004, OR = 0.65 (95% CI = 0.49-0.88)) and 2.8% vs. 7% in the virus+ vs. virus- group (p = 0.002, OR = 0.385, (95% CI = 0.203-0.728)). The male gender, an age < 1 month, leukocytosis > 15 × 109/L, or a CRP > 2 mg/dL increased the risk of SBIs. Respiratory symptoms or a confirmed viral infection reduced the risk of SBIs in the presence of the above risk factors.
CONCLUSIONS: Respiratory symptoms and a positive viral test decreased the risk of SBIs. Combining rapid viral testing with clinical variables may identify low-risk infants. Despite the relatively low risk of SBIs in individuals with viral infections, conducting prospective studies remains essential for accurately predicting the occurrence of these potentially life-threatening infections.
摘要：
目的：我们旨在评估呼吸道症状和病毒检测阳性对严重细菌感染（SBIs）风险的影响。
方法：进行了一项回顾性研究，包括2001年至2022年在以色列北部一家三级医院出现发热的婴儿（0-60天）。人口统计,临床,并收集了实验室参数，并分析了SBIs的危险因素。
结果：来自3106名婴儿的数据，包括血液数据,尿液,和脑脊液培养，在96.6%中获得了，89%,29%的病例，分别。1312名婴儿出现无呼吸道症状的发烧（仅发烧），而1794年有发烧和呼吸道症状-427对呼吸道病毒（病毒+）呈阳性，759检测阴性（病毒-），和608没有测试。SBI率为5.1%，而不是发热和呼吸组的7.5%与仅发热组（p=0.004，OR=0.65（95％CI=0.49-0.88））和2.8％vs.7%的病毒+vs.病毒组(p=0.002，OR=0.385，(95%CI=0.203-0.728))。男性性别,年龄<1个月，白细胞增多>15×109/L，或CRP>2mg/dL会增加SBIs的风险。在存在上述危险因素的情况下，呼吸道症状或确诊的病毒感染降低了SBIs的风险。
结论：呼吸道症状和阳性病毒检测降低了SBI的风险。将快速病毒检测与临床变量相结合可以识别低风险婴儿。尽管SBI在病毒感染个体中的风险相对较低，进行前瞻性研究对于准确预测这些可能危及生命的感染的发生仍然至关重要.
方法：进行了一项回顾性研究，包括2001年至2022年在以色列北部一家三级医院出现发热的婴儿（0-60天）。人口统计,临床,并收集了实验室参数，并分析了SBIs的危险因素。
结果：来自3106名婴儿的数据，包括血液数据,尿液,和脑脊液培养，在96.6%中获得了，89%,29%的病例，分别。1312名婴儿出现无呼吸道症状的发烧（仅发烧），而1794年有发烧和呼吸道症状-427对呼吸道病毒（病毒+）呈阳性，759检测阴性（病毒-），和608没有测试。SBI率为5.1%，而不是发热和呼吸组的7.5%与仅发热组（p=0.004，OR=0.65（95％CI=0.49-0.88））和2.8％vs.7%的病毒+vs.病毒组(p=0.002，OR=0.385，(95%CI=0.203-0.728))。男性性别,年龄<1个月，白细胞增多>15×109/L，或CRP>2mg/dL会增加SBIs的风险。在存在上述危险因素的情况下，呼吸道症状或确诊的病毒感染降低了SBIs的风险。
结论：呼吸道症状和阳性病毒检测降低了SBI的风险。将快速病毒检测与临床变量相结合可以识别低风险婴儿。尽管SBI在病毒感染个体中的风险相对较低，进行前瞻性研究对于准确预测这些可能危及生命的感染的发生仍然至关重要.
