Incidence and aetiology of serious viral infections in young febrile infants

Hayakawa, Isao; Nomura, Osamu; Uda, Kazuhiro; Funakoshi, Yu; Sakakibara, Hiroshi; Horikoshi, Yuho

doi:10.1111/jpc.14692

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…RSV infections account for a majority of outpatient and inpatient cases of children with respiratory symptoms in Japan [11,105]. RSV notifications have increased in Japan; however, since late 2011, the interpretation of trends has been challenging owing to a suspected increase in the testing frequency and the expansion of the insurance coverage for RSV testing to include certain outpatients [45].…”

Section: Discussionmentioning

confidence: 99%

Disease burden of respiratory syncytial virus infection in the pediatric population in Japan

Nagasawa

Ishiwada

2022

Journal of Infection and Chemotherapy

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Introduction: Respiratory syncytial virus (RSV) is one of the most common causes of lower respiratory tract infections in children aged <5 years and is associated with long-term respiratory morbidities such as recurrent wheezing and asthma, decreased lung function, and allergic sensitization. The objective of this review was to evaluate the epidemiology and burden of RSV infection in the pediatric population in Japan. Methods: Studies indexed in PubMed and ICHUSHI databases during January 2010-December 2020 were manually reviewed. Data on proportion of RSV infections, seasonality, length of stay (LoS), mortality, medical expenses, and palivizumab use were extracted from the selected articles. Results: Ninety-three articles were included (PubMed, 64; ICHUSHI, 29). The proportion of patients/samples with an RSV infection was 5.5%-66.7%, and 6.0%-29.9% in the inpatient and outpatient departments, respectively. RSV infections generally occurred during autumn/winter; however, recently the peak has shifted to summer. The LoS was variable and depended on factors such as age, infection severity, wheezing, and RSV subgroups. Mortality rates varied from <1% to 19% depending on the infection severity. The average daily hospitalization and intensive care unit cost was JPY 34,548 while intensive care unit incurred an additional cost of JPY 541,293. Palivizumab was indicated for high-risk infants and 0%-3% of patients required hospitalization despite palivizumab use. Conclusions: RSV imposes a significant burden on the Japanese healthcare system, suggesting a need to create awareness among caregivers of children, pregnant women and healthcare professionals to ensure early recognition of infection and adequate treatment or prophylaxis. Authorship statementBoth authors have made substantial contributions to all of the following and meet the ICMJE authorship criteria: (1) conception and design of the study and the acquisition, analysis, and interpretation of data; (2) drafting the article and revising it critically for important intellectual content; and (3) final approval of the version to be submitted.

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Section: Discussionmentioning

confidence: 99%

Disease burden of respiratory syncytial virus infection in the pediatric population in Japan

Nagasawa

Ishiwada

2022

Journal of Infection and Chemotherapy

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“…There were approximately 38,000 annual pediatric visits to the ED of the hospital. While the initial patient management is usually provided by pediatric or emergency medicine residents and pediatric emergency medicine fellows, board-certificated emergency medicine physicians or pediatricians supervise patient care [ 15 , 16 ]. Patients with sepsis or suspected sepsis were treated based on the institutional protocol by following the International Pediatric Sepsis Consensus Conference (2005) [ 17 ] and Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock (2012) [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Predictor of Early Administration of Antibiotics and a Volume Resuscitation for Young Infants with Septic Shock

et al. 2021

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(1) Background: It is critical to administer antibiotics and fluid bolus within 1 h of recognizing sepsis in pediatric patients. This study aimed to identify the predictor of the successful completion of a 1-h sepsis bundle for infants with suspected sepsis. (2) Methods: This is an observational study using a prospective registry including febrile young infants (aged < 90 days) who visited a pediatric emergency department with a core body temperature of 38.0 °C or higher and 36.0 °C or lower. Univariate and logistic regression analyses were conducted to determine the predictor (s) of successful sepsis bundle completion. (3) Results: Of the 323 registered patients, 118 patients with suspected sepsis were analyzed, and 38 patients (32.2%) received a bundle-compliant treatment. Among potential variables, such as age, sex, and vital sign parameters, the logistic regression analysis showed that heart rate (odds ratio: OR 1.02; 95% confidence interval: 1.00–1.04) is a significant predictor of the completion of a 1-h sepsis bundle. (4) Conclusions: We found that tachycardia facilitated the sepsis recognition and promoted the successful completion of a 1-h sepsis bundle for young infants with suspected septic shock and a possible indicator for improving the quality of the team-based sepsis management.

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“…We defined a serious infection in the following manner by applying the definition used in previous studies that covers both bacterial and viral infections [4,21,22].…”

Section: Definitionmentioning

confidence: 99%

“…Diagnosing viral infections was emphasized less due to the self-limiting clinical course of most viral infections. However, recent studies have shown the importance of diagnosing viral infections in the emergency department (ED) due to the fact that several types of viral infection can cause respiratory failure, septic shock, or central nervous system dysfunction requiring intensive care, possibly resulting in unfavorable outcomes in young infants [3][4][5][6]. This has led some researchers to argue for the need to diagnose viral infections in infants [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Limited Utility of SIRS Criteria for Identifying Serious Infections in Febrile Young Infants

et al. 2021

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(1) Background: Young infants have a high risk of serious infection. The Systematic Inflammatory Response Syndrome (SIRS) criteria can be useful to identify both serious bacterial and viral infections. The aims of this study were to evaluate the diagnostic performance of the SIRS criteria for identifying serious infections in febrile young infants and to identify potential clinical predictors of such infections. (2) Methods: We conducted this prospective cohort study including febrile young infants (aged < 90 days) seen at the emergency department with a body temperature of 38.0 °C or higher. We calculated the diagnostic performance parameters and conducted the logistic regression analysis to identify the predictors of serious infection. (3) Results: Of 311 enrolled patients, 36.7% (n = 114) met the SIRS criteria and 28.6% (n = 89) had a serious infection. The sensitivity, specificity, positive predictive value, and positive likelihood ratio of the SIRS criteria for serious infection was 45.9%, 69.4%, 43.5%, 71.4%, 1.5, and 0.8, respectively. Logistic regression showed that male gender, body temperature ≥ 38.5 °C, heart rate ≥ 178 bpm, and age ≤ 50 days were significant predictors. (4) Conclusions: The performance of the SIRS criteria for predicting serious infections among febrile young infants was poor.

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Incidence and aetiology of serious viral infections in young febrile infants

Cited by 7 publications

References 17 publications

Disease burden of respiratory syncytial virus infection in the pediatric population in Japan

Disease burden of respiratory syncytial virus infection in the pediatric population in Japan

Predictor of Early Administration of Antibiotics and a Volume Resuscitation for Young Infants with Septic Shock

Limited Utility of SIRS Criteria for Identifying Serious Infections in Febrile Young Infants

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