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December 14, 2022
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Bacterial infections in infants fall to prepandemic levels, study finds

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The prevalence of bacterial infections in hospitalized infants — after rising during the first year of the COVID-19 pandemic — fell to prepandemic levels earlier this year, according to a study published in Pediatrics.

Co-author Paul L. Aronson, MD, MHS, a professor of pediatric emergency medicine at Yale School of Medicine, told Healio that the research was inspired by various studies conducted in single health systems in 2020 that reported a “significantly” higher percentage of febrile infants with bacterial infections in the first year of the pandemic compared with historic numbers.

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Bacterial infections in hospitalized infants have decreased. Source: Adobe Stock
Paul L. Aronson

“Historically, [among] febrile infants in that first 60 days of life who come into the ED with fever, about 10% will have a UTI and about 2% will have a blood infection and 0.5% to 1% will have meningitis,” Aronson said.

Aronson and colleagues theorized that the rates were higher during the first year of the pandemic “because, just relatively, we were getting less infants who had fever due to other causes,” Aronson said.

Aronson and colleagues conducted retrospective a multicenter, cross-sectional study encompassing 97 hospitals in the U.S. and Canada. They included well-appearing infants aged 8 to 60 days who had temperatures greater than or equal to 38° C (100.4° F), and an ED visit or hospitalization between Nov. 1, 2020, and March 31, 2022.

“The other thing we looked at was the association of COVID-19 prevalence,” Aronson said. “[We were] looking at the month-by-month proportion of infants who had COVID-19, and whether more infants with COVID-19 that month [were] associated with an individual infant’s odds of having a bacterial infection.”

Among the 9,112 infants studied, 6.6% were found to have a UTI, whereas 1.8% had bacteremia without meningitis and 0.5% had bacterial meningitis — in line with historic levels.

“What we do show is that the prevalence of infection over time has returned to sort of historical levels, which informs sort of how we approach [these infections] and evaluate them,” Aronson said.