Occult Serious Bacterial Infections in Neonates and Infants Up to Three Months of Age with Bronchiolitis: Are Invasive Cultures Required?
Domenico Umberto De RoseVenere CortazzoMarilena AgostaPaola BernaschiMaria Paola RonchettiVelia Chiara Di MaioAlessandra Di PedeJole RechichiAnnabella BragugliaCarlo Federico PernoAndrea DottaPublished in: Antibiotics (Basel, Switzerland) (2024)
(1) Background: The literature reports a low risk of serious bacterial infections (SBIs) in febrile infants presenting with bronchiolitis or respiratory syncytial virus infection, but current microbiological techniques have a higher accuracy. (2) Methods: We assessed the risk of SBIs in neonates and infants with bronchiolitis from 2021 to 2023. We also evaluated C-reactive protein, procalcitonin, and leukocyte values. (3) Results: We included 242 infants. Blood cultures (BCs) were performed in 66/242 patients, with a positivity rate of 9.1% (including one BC with Staphylococcus hominis , considered as a contaminant). The cerebrospinal fluid culture was performed in 6/242 patients, and the results were all negative. Infection markers did not discriminate infants with positive BCs from those with negative ones. (4) Conclusions: Blood cultures should be performed in neonates and young infants with bronchiolitis fever, as the sepsis risk is not negligible. Conversely, our proposed algorithm is to wait for the respiratory panel results before decision-making for a lumbar puncture. Further studies are needed to understand lumbar puncture requirements.
Keyphrases
- respiratory syncytial virus
- decision making
- minimally invasive
- end stage renal disease
- systematic review
- intensive care unit
- ejection fraction
- acute kidney injury
- low birth weight
- emergency department
- newly diagnosed
- machine learning
- prognostic factors
- deep learning
- case report
- peritoneal dialysis
- biofilm formation
- ultrasound guided
- adverse drug
- drug induced
- neural network