ORIGINAL ARTICLE

Bacteraemia and antibiotic use in respiratory syncytial virus infections

P Bloomfield¹, D Dalton², A Karleka³, A Kesson³, G Duncan⁴, D Isaacs^1,5

¹ Departments of Immunology and Infectious Diseases, The Children’s Hospital at Westmead, Westmead, NSW, 2145, Australia
² Department of Nursing, The Children’s Hospital at Westmead, Westmead, NSW, 2145, Australia
³ Department of Pathology, The Children’s Hospital at Westmead, Westmead, NSW, 2145, Australia
⁴ Clinical Epidemiology Unit, The Children’s Hospital at Westmead, Westmead, NSW, 2145, Australia
⁵ University of Sydney, NSW, 2006, Australia

Correspondence to:
Correspondence to:
Prof. D Isaacs
Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia; davidi{at}chw.edu.au

Aims: To examine the frequency of and risk factors for bacteraemia in children hospitalised with respiratory syncytial virus (RSV) infection; and to determine current use of antibiotics in hospitalised children with RSV infection.

Methods: Retrospective study of all children, aged 0–14 years, admitted to a tertiary children’s hospital with proven RSV infection over a four year period. Children with concurrent bacteraemia and RSV infection were identified, and risk factors examined for bacteraemia. The case notes of a randomly selected comparison sample of 100 of these RSV infected children were examined to assess antibiotic use and population incidence of risk factors for severe RSV infection.

Results: A total of 1795 children had proven RSV infection, and blood cultures were sent on 861 (48%). Eleven (0.6%) of the 1795 RSV positive children had bacteraemia. RSV positive children had a significantly higher incidence of bacteraemia if they had nosocomial RSV infection (6.5%), cyanotic congenital heart disease (6.6%), or were admitted to the paediatric intensive care unit (2.9%). Forty five (45%) of the random comparison sample of RSV infected children received antibiotics.

Conclusions: Bacteraemia is rare in RSV infection. Children with RSV infection are more likely to be bacteraemic, however, if they have nosocomial RSV infection, cyanotic congenital heart disease, or require intensive care unit admission.

Keywords: respiratory syncytial virus; pneumonia; septicaemia; bronchiolitis; antibiotics; nosocomial infection

Abbreviations: CCHD, cyanotic congenital heart disease; CI, confidence interval; CPAP, continuous positive airways pressure; NICU, neonatal intensive care unit; NPS, nasopharyngeal secretions; OR, odds ratio; PICU, paediatric intensive care unit; RSV, respiratory syncytial virus

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