Contribution of Rapid Influenza Antigen Test to Management of Febrile Young Infants without a Focus

Abstract

Background: The aim of this study was to evaluate the application of the rapid influenza antigen test and the contribution of the test result to patient management in febrile infants aged 29‒90 days. Methods: The medical records of febrile infants without a focus who presented during influenza seasons from 2017‒2019 were analyzed retrospectively. The study was carried out in the Department of Pediatric Emergency, Dr. Sami Ulus Maternity and Children’s Training and Research Hospital. The demographic characteristics, clinical and laboratory findings, and management of the patients were examined. The patients were divided into two groups as ‘with’ and ‘without’ testing based on whether a rapid influenza antigen test was performed or not. Test results were categorized as positive or negative. Serious bacterial infection (SBI) risk and patient management were evaluated according to test results. Results: A total of 173 patients (110 males/63 females) were evaluated. The influenza test was performed in 94 (54.3%) patients, and 31.9% were positive. SBI was present in 8.7% of all patients. The mean values of white blood cell (WBC), absolute neutrophil, platelet count, C-reactive protein (CRP) and, lumbar puncture, hospitalization, and initiation of antibiotic therapy were significantly lower in the positive group compared to the negative and without testing groups (P<0.05). Conclusion: This study showed that using the influenza test in the emergency department in young febrile infants significantly reduced the use of antibiotics, hospitalization and the implementation of invasive procedures such as lumbar puncture, and the risk of SBI was not increased.