Respiratory viral testing for young febrile infants presenting to emergency care: a planned secondary analysis of the Febrile Infants Diagnostic assessment and Outcome (FIDO) prospective observational cohort study

Jordan Evans*, Etimbuk Umana, Thomas Waterfield, FIDO Study Group in collaboration with PERUKI

*Corresponding author for this work

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Abstract

Objective
To describe the association of respiratory viral test results and the risk of invasive bacterial infection (IBI) for febrile young infants presenting to emergency care.

Design
A planned secondary analysis within the Febrile Infants Diagnostic assessment and Outcome (FIDO) study, a prospective multicentre observational cohort study conducted across the UK and Ireland.

Setting
35 paediatric emergency departments and assessment units across the UK and Ireland between 6 July 2022 and 31 August 2023.

Patients
Febrile infants aged 90 days and under presenting to emergency care.

Main outcome measures
IBI (meningitis or bacteraemia) among febrile infants, undergoing respiratory viral testing for respiratory syncytial virus (RSV), influenza and SARS-CoV-2.

Results
1395 out of 1821 participants underwent respiratory viral testing, of those tested 339 (24.5%) tested positive for at least one of, SARS-CoV-2, RSV or influenza. A total of 45 infants (3.2%) were diagnosed with IBI. Of these, IBI occurred in 40 out of 1056 (3.8%) participants with a negative viral test and 5 out of 339 (1.5%) occurred in participants with a positive viral respiratory test (p=0.034). Infants aged 29 days and older with a positive respiratory viral test had a significantly lower rate of IBI (0.7%) compared with those with a negative test (3.2%) (p=0.015).Conclusions Young febrile infants with a positive respiratory viral test for SARS-CoV-2, RSV or influenza are at lower risk of IBI. Infants over 28 days of age with a positive viral test represent the lowest risk cohort.

Original languageEnglish
Number of pages6
JournalArchives of Disease in Childhood
Early online date02 Oct 2024
DOIs
Publication statusEarly online date - 02 Oct 2024

Publications and Copyright Policy

This work is licensed under Queen’s Research Publications and Copyright Policy.

Keywords

  • emergency care
  • infectious disease medicine
  • paediatric emergency medicine
  • respiratory medicine
  • sepsis

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