Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2-Reference-Cited by-同舟云学术

Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2

Published:2023-05-12 Issue:5 Volume:6 Page:e2313354
ISSN:2574-3805
Container-title:JAMA Network Open
language:en
Short-container-title:JAMA Netw Open

Author:

Aronson Paul L.¹,Louie Jeffrey P.²,Kerns Ellen³,Jennings Brittany⁴,Magee Sloane⁴,Wang Marie E.⁵,Gupta Nisha⁶,Kovaleski Christopher⁷,McDaniel Lauren M.⁸⁹,McDaniel Corrie E.¹⁰,Agbim Chisom¹¹,Amadasun Owen¹¹,Beam Nicholas¹¹,Beamon Bradley D.¹¹,Becker Heather J.¹¹,Bedard Emma M.¹¹,Biondi Eric¹¹,Boulet Jenna¹¹,Bray-Aschenbrenner Amelia¹¹,Brooks Rona¹¹,Chen Clifford¹¹,Corboy Jacqueline B.¹¹,Dawlabani Nickolas¹¹,De Angulo Guillermo¹¹,Demie Senayit¹¹,Drexler Jennifer¹¹,Dudley Nanette¹¹,Ellis Andrew¹¹,Fath Kelsey¹¹,Frauenfelder Alejandra¹¹,Gill Jeff¹¹,Graf Thomas¹¹,Grageda Melissa¹¹,Greening Heidi¹¹,Griffin Alison M¹¹,Groen Amy¹¹,Guernsey III David T.¹¹,Gustafson Sarah¹¹,Hancock W Caleb¹¹,Iyer Sujit¹¹,Jaiyeola Patti Jo¹¹,Jayanth Aditi¹¹,Jennings Rebecca M.¹¹,Kachan-Liu Svetlana S.¹¹,Kamat Aditi¹¹,Kennedy Isaac J.¹¹,Khateeb Loay¹¹,Khilji Ohmed¹¹,Kleweno Elizabeth A.¹¹,Kumar Anika¹¹,Kwon Stephanie¹¹,La Alicia¹¹,Laeven-Sessions Petra¹¹,Le Kaitlyn Phuong¹¹,Leazer Rianna C.¹¹,Levasseur Kelly A.¹¹,Lewis Emilee C.¹¹,Maalouli Walid M.¹¹,Mackenzie Bonnie S.¹¹,Mahoney Kathleen E.¹¹,Margulis Deborah M.¹¹,Maskin Lauren¹¹,McCarty Emily¹¹,Monroy Alexa N.¹¹,Morrison John M.¹¹,Myszewski Jennifer H.¹¹,Nadeau Nicole L.¹¹,Nagappan Suresh¹¹,Newcomer Kristen¹¹,Nordstrom Matthew C.¹¹,Nguyen Diana¹¹,O'Day Peter¹¹,Oumarbaeva-Malone Yuliya¹¹,Parlin Ursula¹¹,Peters Summer¹¹,Piroutek Mary Jane¹¹,Quarrie Renee¹¹,Rice Kerrilynn¹¹,Romano Teresa M.¹¹,Rooholamini Sahar N.¹¹,Schroeder Cynthia L.¹¹,Segar Elizabeth K.¹¹,Seitzinger Patrick¹¹,Sharma Suparna¹¹,Simpson Blair E.¹¹,Singh Prachi¹¹,Sobeih Yasmine¹¹,Sojar Sakina¹¹,Srinivasan Karthik¹¹,Sterrett Emily C.¹¹,Swift-Taylor Mary Elizabeth¹¹,Szkola Sara¹¹,Thull-Freedman Jennifer¹¹,Topoz Irina¹¹,Vayngortin Tatyana¹¹,Veit Christopher¹¹,Ventura-Polanco Yenimar¹¹,Wallace Wu Ashley¹¹,Weiss Lindsay¹¹,Wong Erika K.¹¹,Zafar Sara¹¹,

Affiliation:

1. Section of Pediatric Emergency Medicine, Departments of Pediatrics and of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut

2. Division of Emergency Medicine, University of Minnesota, Masonic Children's Hospital, Minneapolis

3. Division of Child Health Policy, Department of Pediatrics, University of Nebraska Medical Center, Omaha

4. American Academy of Pediatrics, Itasca, Illinois

5. Division of Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Children’s Hospital Stanford, Palo Alto, California

6. Division of Hospital Medicine, Inova Children’s Hospital, Falls Church, Virginia

7. Division of Pediatric Emergency Medicine, Department of Pediatrics, Inova Children’s Hospital, Falls Church, Virginia

8. Division of Hospital Medicine, Department of Pediatrics, Johns Hopkins Children’s Center, Baltimore, Maryland

9. Now with Division of Hospital Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle Children’s Hospital, Seattle

10. Division of Hospital Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle Children’s Hospital, Seattle

11. for the AAP REVISE II QI Collaborative

Abstract

ImportanceThe prevalence of urinary tract infection (UTI), bacteremia, and bacterial meningitis in febrile infants with SARS-CoV-2 is largely unknown. Knowledge of the prevalence of these bacterial infections among febrile infants with SARS-CoV-2 can inform clinical decision-making.ObjectiveTo describe the prevalence of UTI, bacteremia, and bacterial meningitis among febrile infants aged 8 to 60 days with SARS-CoV-2 vs without SARS-CoV-2.Design, Setting, and ParticipantsThis multicenter cross-sectional study was conducted as part of a quality improvement initiative at 106 hospitals in the US and Canada. Participants included full-term, previously healthy, well-appearing infants aged 8 to 60 days without bronchiolitis and with a temperature of at least 38 °C who underwent SARS-CoV-2 testing in the emergency department or hospital between November 1, 2020, and October 31, 2022. Statistical analysis was performed from September 2022 to March 2023.ExposuresSARS-CoV-2 positivity and, for SARS-CoV-2–positive infants, the presence of normal vs abnormal inflammatory marker (IM) levels.Main Outcomes and MeasuresOutcomes were ascertained by medical record review and included the prevalence of UTI, bacteremia without meningitis, and bacterial meningitis. The proportion of infants who were SARS-CoV-2 positive vs negative was calculated for each infection type, and stratified by age group and normal vs abnormal IMs.ResultsAmong 14 402 febrile infants with SARS-CoV-2 testing, 9841 (68.3%) were aged 29 to 60 days; 8143 (56.5%) were male; and 3753 (26.1%) tested positive. Compared with infants who tested negative, a lower proportion of infants who tested positive for SARS-CoV-2 had UTI (0.8% [95% CI, 0.5%-1.1%]) vs 7.6% [95% CI, 7.1%-8.1%]), bacteremia without meningitis (0.2% [95% CI, 0.1%-0.3%] vs 2.1% [95% CI, 1.8%-2.4%]), and bacterial meningitis (&lt;0.1% [95% CI, 0%-0.2%] vs 0.5% [95% CI, 0.4%-0.6%]). Among infants aged 29 to 60 days who tested positive for SARS-CoV-2, 0.4% (95% CI, 0.2%-0.7%) had UTI, less than 0.1% (95% CI, 0%-0.2%) had bacteremia, and less than 0.1% (95% CI, 0%-0.1%) had meningitis. Among SARS-CoV-2–positive infants, a lower proportion of those with normal IMs had bacteremia and/or bacterial meningitis compared with those with abnormal IMs (&lt;0.1% [0%-0.2%] vs 1.8% [0.6%-3.1%]).Conclusions and RelevanceThe prevalence of UTI, bacteremia, and bacterial meningitis was lower for febrile infants who tested positive for SARS-CoV-2, particularly infants aged 29 to 60 days and those with normal IMs. These findings may help inform management of certain febrile infants who test positive for SARS-CoV-2.

Publisher

American Medical Association (AMA)

Subject

General Medicine

Link

https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2804850/aronson_2023_oi_230410_1685715718.47923.pdf

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