{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:28:47Z","timestamp":1761647327104,"version":"3.40.5"},"reference-count":43,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,3,1]]},"abstract":"<jats:p>Objective. Previous studies of febrile children who were 3 to 36 months of age and had clinically recognizable viral syndromes have shown low rates of concurrent bacteremia. We sought to determine the prevalence of serious bacterial infections (SBIs) among children with influenza A, a viral syndrome that can be established definitively by specific tests.<\/jats:p>\n               <jats:p>Methods. We performed a retrospective cross-sectional study of patients who were 0 to 36 months of age and presented with fever to the emergency department (ED) over 4 consecutive influenza seasons. Chest radiographs and urine and cerebrospinal fluid cultures also were reviewed.<\/jats:p>\n               <jats:p>Results. Of 705 included patients, 163 (23%) were influenza positive (IP) and 542 (77%) were influenza negative (IN). Only 1 IP patient was bacteremic (0.6%) versus 23 of the 542 IN control subjects (4.2%). Two (1.8%) of 110 IP cases had urinary tract infections versus 38 (9.9%) of the 382 IN control subjects. Thirteen (25.4%) of 51 IP patients had radiographic evidence of pneumonia versus 99 (41.9%) of 236 IN control subjects. There were no cases of meningitis in 41 cerebrospinal fluid samples obtained from IP patients versus 4 (2.2%) cases of culture-positive meningitis in 179 IN control subjects. A total of 16 (9.8%) SBIs were identified in the IP cases versus 153 (28.2%) in the IN control subjects.<\/jats:p>\n               <jats:p>Conclusions. Febrile children with influenza A had a lower prevalence of bacteremia, urinary tract infections, consolidative pneumonia, or any SBI compared with those without influenza A infection in this study.<\/jats:p>","DOI":"10.1542\/peds.2004-1112","type":"journal-article","created":{"date-parts":[[2005,3,1]],"date-time":"2005-03-01T19:22:35Z","timestamp":1109704955000},"page":"710-718","source":"Crossref","is-referenced-by-count":54,"title":["Retrospective Review of Serious Bacterial Infections in Infants Who Are 0 to 36 Months of Age and Have Influenza A Infection"],"prefix":"10.1542","volume":"115","author":[{"given":"Hannah F.","family":"Smitherman","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Chantal","family":"Caviness","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles G.","family":"Macias","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2005,3,1]]},"reference":[{"key":"2021121021585253000_R1","unstructured":"American Academy of Pediatrics. Report of the Committee on Infectious Diseases. Redbook. Elk Grove Village, IL: American Academy of Pediatrics; 1997:309\u2013315"},{"key":"2021121021585253000_R2","unstructured":"Arias E, Smith BL. Deaths: data for 2001. Natl Vital Stat Rep.\u20082003;51:1\u201344"},{"key":"2021121021585253000_R3","unstructured":"Centers for Disease Control and Prevention. Influenza Summary Update (week ending February 24, 2001-week 08). Report prepared March 1, 2001. Available at: www.cdc.gov\/nicidod\/diseases\/flu\/weeklyarchives\/week08.htm"},{"key":"2021121021585253000_R4","unstructured":"Centers for Disease Control and Prevention. Clinical Features of Influenza. Available at: www.cdc.gov\/ncidad\/diseases\/flu\/fluinfo.htm"},{"key":"2021121021585253000_R5","doi-asserted-by":"crossref","unstructured":"Nelson DS, Walsh K, Fleisher GR. Spectrum and frequency of pediatric illness presenting to a general emergency department. Pediatr Emerg Care.\u20081991;7:67\u201371","DOI":"10.1097\/00006565-199104000-00001"},{"key":"2021121021585253000_R6","doi-asserted-by":"crossref","unstructured":"Greenes DS, Harper MB. Low risk of bacteremia in febrile children with recognizable viral syndromes. Pediatr Infect Dis J.\u20081999;18:258\u2013261","DOI":"10.1097\/00006454-199903000-00010"},{"key":"2021121021585253000_R7","doi-asserted-by":"crossref","unstructured":"Liebelt EL. Diagnostic testing for serious bacterial infections in infants aged 90 days or younger with bronchiolitis. Arch Pediatr Adolesc Med.\u20081999;153:525\u2013530","DOI":"10.1001\/archpedi.153.5.525"},{"key":"2021121021585253000_R8","unstructured":"Antonow JA. Use of respiratory syncytial virus testing could safely eliminate many sepsis evaluations. Arch Pediatr Adolesc Med.\u20081999;153:1310\u20131311"},{"key":"2021121021585253000_R9","doi-asserted-by":"crossref","unstructured":"Kupperman N, Bank DE, Walton EA, Senac MO Jr, McCaslin I. Risks for bacteremia and urinary tract infections in young febrile children with bronchiolitis. Arch Pediatr Adolesc Med.\u20081997;151:1207\u20131214","DOI":"10.1001\/archpedi.1997.02170490033006"},{"key":"2021121021585253000_R10","doi-asserted-by":"crossref","unstructured":"Melendez E, Harper MB. Utility of sepsis evaluation in infants 90 days of age or younger with fever and clinical bronchiolitis. Pediatr Infect Dis J.\u20082003;22:1053\u20131056","DOI":"10.1097\/01.inf.0000101296.68993.4d"},{"key":"2021121021585253000_R11","doi-asserted-by":"crossref","unstructured":"Lee GM, Harper MB. Risk of bacteremia for febrile children in the post-Haemophilus influenzae type B era. Arch Pediatr Adolesc Med.\u20081998;152:624\u2013628","DOI":"10.1001\/archpedi.152.7.624"},{"key":"2021121021585253000_R12","doi-asserted-by":"crossref","unstructured":"Kuppermann N, Fleisher GR, Jaffe DM. Predictors of occult bacteremia in young febrile children. Ann Emerg Med.\u20081998;31:679\u2013687","DOI":"10.1016\/S0196-0644(98)70225-2"},{"key":"2021121021585253000_R13","doi-asserted-by":"crossref","unstructured":"Verbon-Maciolek MA, Nijhuis M, van Loon AM, et al. Diagnosis of enterovirus infection in the first 2 months of life by real-time polymerase chain reaction. Clin Infect Dis.\u20082003;37:1\u20136","DOI":"10.1086\/375222"},{"key":"2021121021585253000_R14","doi-asserted-by":"crossref","unstructured":"Levine DA, Platt S, Dayan PS, et al. Risks of serious bacterial infection in young febrile infants with respiratory syncytial virus infections. Pediatrics.\u20082004;113:1728\u20131734","DOI":"10.1542\/peds.113.6.1728"},{"key":"2021121021585253000_R15","doi-asserted-by":"crossref","unstructured":"Serwint JR, Miller RM. Why diagnose influenza in hospitalized pediatric patients?Pediatr Infect Dis J.\u20081993;12:200\u2013204","DOI":"10.1097\/00006454-199303000-00005"},{"key":"2021121021585253000_R16","doi-asserted-by":"crossref","unstructured":"Noyola DE, Demmler GJ. Effect of rapid diagnosis on management of Influenza A infections. Pediatr Infect Dis J.\u20082000;19:303\u2013307","DOI":"10.1097\/00006454-200004000-00008"},{"key":"2021121021585253000_R17","unstructured":"Directigen Flu A [package insert]. Sparks, MD: Becton Dickinson; 2002"},{"key":"2021121021585253000_R18","unstructured":"Feigin RD, Cherry JD, Fletcher J. Textbook of Pediatric Infectious Diseases. Philadelphia, PA: WB Saunders; 1998"},{"key":"2021121021585253000_R19","doi-asserted-by":"crossref","unstructured":"Segal GS, Chamberlain JM. Resource utilization and contaminated blood cultures in children at risk for occult bacteremia. Arch Pediatr Adolesc Med.\u20082000;154:469\u2013473","DOI":"10.1001\/archpedi.154.5.469"},{"key":"2021121021585253000_R20","doi-asserted-by":"crossref","unstructured":"Kornberg AE, Jain N, Dannenhoffer R. Evaluation of false-positive blood cultures: guidelines for early detection of contaminated cultures in febrile children. Pediatr Emerg Care.\u20081994;10:20\u201322","DOI":"10.1097\/00006565-199402000-00006"},{"key":"2021121021585253000_R21","doi-asserted-by":"crossref","unstructured":"Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Pediatrics.103:843-852","DOI":"10.1542\/peds.103.4.843"},{"key":"2021121021585253000_R22","doi-asserted-by":"crossref","unstructured":"Shaw KN, Gorelick MH. Urinary tract infection in the pediatric patient. Pediatr Clin North Am.\u20081999;46:1111\u20131124","DOI":"10.1016\/S0031-3955(05)70177-2"},{"key":"2021121021585253000_R23","doi-asserted-by":"crossref","unstructured":"Dagan R, Powel KR, Hall CB. Identification of infants unlikely to have SBI although hospitalized for suspected sepsis. J Pediatr.\u20081985;107:855\u2013860","DOI":"10.1016\/S0022-3476(85)80175-X"},{"key":"2021121021585253000_R24","doi-asserted-by":"crossref","unstructured":"Alpern WR, Alessandrini EA, Bell LM, Shaw KN, Mcgown KL. Occult bacteremia from a pediatric emergency department: current prevalence, time to detection and outcome. Pediatrics.\u20082000;106:505\u2013511","DOI":"10.1542\/peds.106.3.505"},{"key":"2021121021585253000_R25","doi-asserted-by":"crossref","unstructured":"Bachur G, Harper MB. Predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics.\u20082001;108:311\u2013316","DOI":"10.1542\/peds.108.2.311"},{"key":"2021121021585253000_R26","doi-asserted-by":"crossref","unstructured":"Bonadio WA. The history and physical assessments of the febrile infant. Pedatr Clin North Am.\u20081998;45:65\u201377","DOI":"10.1016\/S0031-3955(05)70583-6"},{"key":"2021121021585253000_R27","unstructured":"Haemophilus influenzae invasive disease among children 2\u20135 years\u2014California 1990\u20131996. MMWR Morb Mortal Wkly Rep.\u20081998;47:737\u2013740"},{"key":"2021121021585253000_R28","doi-asserted-by":"crossref","unstructured":"Adams WG, Deaver KA, Cochi SL, et al. Decline in childhood Haemophilus influenza type B (Hib) disease in the Hib vaccine era. JAMA.\u20081993;269:221\u2013226","DOI":"10.1001\/jama.269.2.221"},{"key":"2021121021585253000_R29","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee of Infectious Disease. Recommendations for the prevention of pneumococcal infections, including the use of pneumococcal conjugate vaccine (Prevnar), pneumococcal polysaccharide vaccine, and antibody prophylaxis. Pediatrics.\u20082000;106:363\u2013366","DOI":"10.1542\/peds.106.2.362"},{"key":"2021121021585253000_R30","doi-asserted-by":"crossref","unstructured":"Kaplan SL, Mason EO, Wald ER, et al. Decrease of invasive pneumococcal infections in children among 8 children's hospitals in the united states after introduction of the 7-valent pneumococcal conjugate vaccine. Pediatrics.\u20082004;113:443\u2013449","DOI":"10.1542\/peds.113.3.443"},{"key":"2021121021585253000_R31","doi-asserted-by":"crossref","unstructured":"Nigrovic LE, Malley R. Evaluation of the febrile child 3-36 months old in the era of pneumococcal conjugate vaccine: focus on occult bacteremia. Clin Pediatr Emerg Med.5:13-19","DOI":"10.1016\/j.cpem.2003.11.009"},{"key":"2021121021585253000_R32","doi-asserted-by":"crossref","unstructured":"Korppi M, Leinonen M, Koskela M, Makela PH, Launiala K. Bacterial co-infections in children hospitalized with respiratory syncytial virus infections. Pediatr Infect Dis J.\u20081989;8:687\u2013692","DOI":"10.1097\/00006454-198910000-00005"},{"key":"2021121021585253000_R33","doi-asserted-by":"crossref","unstructured":"Hament JM, Kimpen JL, Fleer A, Wolfs TF. Respiratory viral infection predisposing for bacterial disease: a concise review. FEMS Immunol Med Microbiol.\u20081990;26:189\u2013195","DOI":"10.1111\/j.1574-695X.1999.tb01389.x"},{"key":"2021121021585253000_R34","doi-asserted-by":"crossref","unstructured":"Peltola VT, McCullers JA. Respiratory viruses predisposing to bacterial infections: role of neuraminidase. Pediatr Infect Dis J.\u20082004;23(suppl):S87\u2013S97","DOI":"10.1097\/01.inf.0000108197.81270.35"},{"key":"2021121021585253000_R35","doi-asserted-by":"crossref","unstructured":"Okamoto S, Kawabala S, Nakagawa I, et al. Influenza A virus-infected hosts boost an invasive type of Streptococcus pyogenes infection in mice. J Virol.\u20082003;77:4104\u20134112","DOI":"10.1128\/JVI.77.7.4104-4112.2003"},{"key":"2021121021585253000_R36","doi-asserted-by":"crossref","unstructured":"McCullers JA, Bartmess KC. Role of neuroaminidase in lethal synergism between Influenza viruses and Streptococcus pneumoniae.J Infect Dis.\u20082003;187:1000\u20131009","DOI":"10.1086\/368163"},{"key":"2021121021585253000_R37","unstructured":"Meadows M. A look at the 2003\u20132004 flu season. FDA Consum.\u20082001;38:9\u201311"},{"key":"2021121021585253000_R38","doi-asserted-by":"crossref","unstructured":"Couch R. Prevention and treatment of Influenza. N Engl J Med.\u20082000;343:1778\u20131787","DOI":"10.1056\/NEJM200012143432407"},{"key":"2021121021585253000_R39","doi-asserted-by":"crossref","unstructured":"Stamboulian D, Bonvehi PE, Nacinovich FM, Cox N. Influenza. Infect Dis Clin North Am.\u20082000;14:141\u2013166","DOI":"10.1016\/S0891-5520(05)70222-1"},{"key":"2021121021585253000_R40","doi-asserted-by":"crossref","unstructured":"Heikkinen T, Ruuskanen O, Waris M, Ziegler T, Arola M, Halonen P. Influenza vaccination in the prevention of acute otitis media in children. Am J Dis Child.\u20081991;145:445\u2013448","DOI":"10.1001\/archpedi.1991.02160040103017"},{"key":"2021121021585253000_R41","unstructured":"Update: influenza activity\u2014United States, 2002\u20132003 season. MMWR Morb Mortal Wkly Rep.\u20082002;51:1095\u20131096"},{"key":"2021121021585253000_R42","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics Committee on Infectious Diseases. Recommendations for Influenza immunization of children. Pediatrics.\u20082004;113:1441\u20131447","DOI":"10.1542\/peds.113.5.1441"},{"key":"2021121021585253000_R43","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Infectious Diseases. Recommended childhood and adolescent immunization schedule\u2014United States, January\u2013June 2004. Pediatrics.\u20082004;113:142\u2013147","DOI":"10.1542\/peds.113.1.142"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/115\/3\/710\/1019896\/zpe00305000710.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/115\/3\/710\/1019896\/zpe00305000710.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T07:28:41Z","timestamp":1639207721000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/115\/3\/710\/67235\/Retrospective-Review-of-Serious-Bacterial"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,3,1]]},"references-count":43,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2005,3,1]]},"published-print":{"date-parts":[[2005,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2004-1112","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2005,3,1]]}}}