By Ethan Covey
The rate of bacterial superinfection in children hospitalized with viral infections is very low, according to data presented at the 50th Critical Care Congress Virtual Event (abstract 695).
Although cases of bacterial superinfection are relatively rare, patients with superinfection are likely to have worse clinical outcomes and use more hospital resources.
“It is clear from the literature that bacterial superinfection exists,” said Nikita Patel, a second-year medical student at the University of Illinois College of Medicine, in Peoria. “But there isn’t a clear consensus on the rate of superinfection.”
The study set out to determine the prevalence of bacterial superinfection in children with respiratory viral infections, and to compare demographic risk factors, hospital course and outcomes between children with and without these superinfections.
The single-center, retrospective chart review focused on children who required hospital admission and had a respiratory viral panel sent within 48 hours of admission from January 2015 through December 2019. Among these patients, the researchers identified those with a positive respiratory, urine or blood culture within 24 hours of admission.
They found 2,192 patients who met the inclusion criteria, 282 of whom were flagged with a positive bacterial culture, 203 of the cultures were identified as “contaminants,” and probably were not pathogenic.
Bacterial superinfection was confirmed in 77 patients, 3.5% of the total. Of these, 0.54% had a positive blood culture, 2% had a positive urine culture, and 0.95% had positive respiratory cultures.
Demographically, patients with bacterial superinfection were more likely to be younger, female and underweight. Many were born prematurely and had congenital heart disease. Children with superinfection also tended to use more hospital resources, including ICU care, IV antibiotics, radiographs and intubation. Similarly, the median cost of care was significantly higher for patients with superinfection, at $3,774 versus $2,344 (P<0.001).
“In the future, it would be interesting to see how COVID-19 affects bacterial superinfection rates and outcomes,” Patel added.
