Bloodstream Infections in Children Hospitalized for Influenza, the Canadian Immunization Monitoring Program Active
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved..
BACKGROUND: We aimed to estimate the proportion of children hospitalized for influenza whose illness was complicated by bloodstream infection, describe their clinical course, and identify the factors associated with bloodstream infection.
METHODS: We performed active surveillance for laboratory-confirmed influenza hospitalizations among children ≤16 years old at the 12 Canadian Immunization Monitoring Program Active hospitals, from the 2010-2011 to 2020-2021 influenza seasons. Factors associated with bloodstream infection were identified using multivariable logistic regression analyses.
RESULTS: Among 9179 laboratory-confirmed influenza hospital admissions, bloodstream infection occurred in 87 children (0.9%). Streptococcus pyogenes (22%), Staphylococcus aureus (18%) and Streptococcus pneumoniae (17%) were the most common bloodstream infection pathogens identified. Children with cancer [adjusted odds ratio (aOR): 2.78; 95% confidence interval (CI): 1.23-5.63], a laboratory-confirmed nonbloodstream bacterial infection (aOR: 14.1; 95% CI: 8.04-24.3) or radiographically-confirmed pneumonia (aOR: 1.87; 95% CI: 1.17-2.97) were more likely to experience a bloodstream infection, whereas children with chronic lung disorders were less likely (aOR: 0.41; 95% CI: 0.19-0.80). Disease severity markers such as intensive care unit admission (aOR: 2.11; 95% CI: 1.27-3.46), mechanical ventilation (aOR: 2.84; 95% CI: 1.63-4.80) and longer hospital length of stay (aOR: 1.02; 95% CI: 1.01-1.03) were associated with bloodstream infection. Bloodstream infection also increased the odds of death (aOR: 13.0; 95% CI: 4.84-29.1) after adjustment for age, influenza virus type and the presence of any at-risk chronic condition.
CONCLUSIONS: Bloodstream infections, although infrequent, are associated with intensive care unit admission, mechanical ventilation, increased hospital length of stay and in-hospital mortality, thus requiring increased levels of care among pediatric influenza hospitalizations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
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| Enthalten in: |
The Pediatric infectious disease journal - 43(2024), 4 vom: 01. März, Seite 301-306 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Modler, Jacqueline [VerfasserIn] |
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| Anmerkungen: |
Date Completed 11.03.2024 Date Revised 25.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/INF.0000000000004199 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM365395927 |
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| 245 | 1 | 0 | |a Bloodstream Infections in Children Hospitalized for Influenza, the Canadian Immunization Monitoring Program Active |
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| 500 | |a Date Completed 11.03.2024 | ||
| 500 | |a Date Revised 25.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: We aimed to estimate the proportion of children hospitalized for influenza whose illness was complicated by bloodstream infection, describe their clinical course, and identify the factors associated with bloodstream infection | ||
| 520 | |a METHODS: We performed active surveillance for laboratory-confirmed influenza hospitalizations among children ≤16 years old at the 12 Canadian Immunization Monitoring Program Active hospitals, from the 2010-2011 to 2020-2021 influenza seasons. Factors associated with bloodstream infection were identified using multivariable logistic regression analyses | ||
| 520 | |a RESULTS: Among 9179 laboratory-confirmed influenza hospital admissions, bloodstream infection occurred in 87 children (0.9%). Streptococcus pyogenes (22%), Staphylococcus aureus (18%) and Streptococcus pneumoniae (17%) were the most common bloodstream infection pathogens identified. Children with cancer [adjusted odds ratio (aOR): 2.78; 95% confidence interval (CI): 1.23-5.63], a laboratory-confirmed nonbloodstream bacterial infection (aOR: 14.1; 95% CI: 8.04-24.3) or radiographically-confirmed pneumonia (aOR: 1.87; 95% CI: 1.17-2.97) were more likely to experience a bloodstream infection, whereas children with chronic lung disorders were less likely (aOR: 0.41; 95% CI: 0.19-0.80). Disease severity markers such as intensive care unit admission (aOR: 2.11; 95% CI: 1.27-3.46), mechanical ventilation (aOR: 2.84; 95% CI: 1.63-4.80) and longer hospital length of stay (aOR: 1.02; 95% CI: 1.01-1.03) were associated with bloodstream infection. Bloodstream infection also increased the odds of death (aOR: 13.0; 95% CI: 4.84-29.1) after adjustment for age, influenza virus type and the presence of any at-risk chronic condition | ||
| 520 | |a CONCLUSIONS: Bloodstream infections, although infrequent, are associated with intensive care unit admission, mechanical ventilation, increased hospital length of stay and in-hospital mortality, thus requiring increased levels of care among pediatric influenza hospitalizations | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Morris, Shaun K |e verfasserin |4 aut | |
| 700 | 1 | |a Bettinger, Julie A |e verfasserin |4 aut | |
| 700 | 1 | |a Bancej, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Burton, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Foo, Cheryl |e verfasserin |4 aut | |
| 700 | 1 | |a Halperin, Scott A |e verfasserin |4 aut | |
| 700 | 1 | |a Jadavji, Taj |e verfasserin |4 aut | |
| 700 | 1 | |a Kazmi, Kescha |e verfasserin |4 aut | |
| 700 | 1 | |a Sadarangani, Manish |e verfasserin |4 aut | |
| 700 | 1 | |a Schober, Tilmann |e verfasserin |4 aut | |
| 700 | 1 | |a Papenburg, Jesse |e verfasserin |4 aut | |
| 700 | 0 | |a Canadian Immunization Monitoring Program Active (IMPACT) Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Bridger, Natalie |e investigator |4 oth | |
| 700 | 1 | |a Top, Karina |e investigator |4 oth | |
| 700 | 1 | |a Thibeault, Roseline |e investigator |4 oth | |
| 700 | 1 | |a Moore, Dorothy L |e investigator |4 oth | |
| 700 | 1 | |a Lebel, Marc |e investigator |4 oth | |
| 700 | 1 | |a Saux, Nicole Le |e investigator |4 oth | |
| 700 | 1 | |a Purewal, Rupeena |e investigator |4 oth | |
| 700 | 1 | |a Sauvé, Laura |e investigator |4 oth | |
| 700 | 1 | |a Bullard, Jared |e investigator |4 oth | |
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