From the Guidelines
Serious bacterial infections are present in 2%-50% of pediatric patients with viral infections, with the prevalence varying depending on the age group and severity of the infection.
Prevalence of Bacterial Infections
- In children younger than 2 years, viral etiologies are more common, with bacterial pathogens isolated in 2%-20% of cases 1.
- In older children, bacterial pneumonia is more common, with Streptococcus pneumoniae being the most common pathogen 1.
- The prevalence of bacterial infections also varies depending on the severity of the infection, with more severe cases having a higher likelihood of bacterial infection 1.
Age-Related Prevalence
- In infants and toddlers, viruses are the most common pathogens, with respiratory syncytial virus being the most frequent 1.
- In school-aged children and young adolescents, bacterial pneumonia is more common, with S. pneumoniae being the most common pathogen 1.
- Atypical pneumonia caused by Mycoplasma pneumoniae is more common in older children and adolescents, accounting for 8%-16% of hospitalizations 1.
Diagnostic Considerations
- The diagnosis of bacterial infections in pediatric patients with viral infections can be challenging, and requires a combination of clinical evaluation, laboratory tests, and imaging studies 1.
- The use of molecular diagnostic techniques, such as PCR, can help identify viral and bacterial pathogens, and guide antibiotic therapy 1.
From the Research
Prevalence of Serious Bacterial Infections in Pediatric Patients with Viral Infections
- The prevalence of serious bacterial infections (SBIs) in pediatric patients with viral infections is a significant concern in the medical field 2, 3, 4, 5, 6.
- Studies have shown that the presence of a viral infection can lower the risk of SBIs in pediatric patients 2, 3, 6.
- A retrospective cross-sectional study found that febrile children with influenza A had a lower prevalence of bacteremia, urinary tract infections, consolidative pneumonia, or any SBI compared to those without influenza A infection 2.
- Another study found that febrile infants with confirmed viral infections had a lower risk of SBIs compared to those without a viral infection, with a significant difference in the occurrence of bacteremia, urinary tract infections, and soft tissue infections 3.
- The incidence of SBIs in hospitalized children with bronchiolitis was found to be 4.2%, with pneumonia being the most common SBI 5.
- A study on young infants with and without viral respiratory infections found that infants with documented respiratory viral pathogens were less likely to have any SBI, UTI, or bacteremia compared to infants with negative viral testing 6.
- The frequency of SBIs in young infants with viral respiratory infections was lower compared to those without viral infections, with a significant difference in the frequency of bacteremia and UTI 6.
Risk Factors for Serious Bacterial Infections
- Invasive mechanical ventilation, elevated C-reactive protein, presence of complex chronic conditions, and PICU admission were associated with an increased risk of SBIs in children hospitalized with bronchiolitis 5.
- The presence of a viral infection can be a protective factor against SBIs in pediatric patients, with a lower risk of bacteremia, urinary tract infections, and soft tissue infections 2, 3, 6.
Incidence of Serious Bacterial Infections
- The incidence of SBIs in febrile infants with viral infections was found to be lower compared to those without viral infections, with a significant difference in the occurrence of bacteremia, urinary tract infections, and soft tissue infections 3.
- The incidence of SBIs in hospitalized children with bronchiolitis was found to be 4.2%, with pneumonia being the most common SBI 5.
- The frequency of SBIs in young infants with viral respiratory infections was lower compared to those without viral infections, with a significant difference in the frequency of bacteremia and UTI 6.