Prevalence of bacterial codetection and outcomes for infants intubated for respiratory infections

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dc.contributor.authorKarsies, Todd
dc.contributor.authorShein, Steven L.
dc.contributor.authorDiaz, Franco
dc.contributor.authorVasquez-Hoyos, Pablo
dc.contributor.authorAlexander, Robin
dc.contributor.authorPon, Steven
dc.contributor.authorGonzález-Dambrauskas, Sebastián
dc.date.accessioned2024-07-30T12:37:24Z
dc.date.available2024-07-30T12:37:24Z
dc.date.issued2024-07-01
dc.description.abstractOBJECTIVES: To determine the prevalence of respiratory bacterial codetection in children younger than 2 years intubated for acute lower respiratory tract infection (LRTI), primarily viral bronchiolitis, and identify the association of codetection with mechanical ventilation duration. MEASUREMENTS AND MAIN RESULTS: Of the 472 analyzed patients (median age 4.5 mo), 55% had a positive respiratory culture and 29% (n = 138) had codetection. 90% received early antibiotics starting at a median of 0.36 hours after respiratory culture. Median (interquartile range) IMV duration was 151 hours (88, 226), and there were 28 deaths (5.3%). Codetection was more common with younger age, a positive respiratory syncytial virus test, and an admission diagnosis of bronchiolitis; it was less common with an admission diagnosis of pneumonia, with admission to a low-/middle-income site, and in those receiving vasopressors. When adjusted for confounders, codetection was not associated with longer IMV duration (adjusted relative risk 0.854 [95% CI 0.684–1.065]). We could not exclude the possibility that codetection might be associated with a 30-hour shorter IMV duration compared with no codetection, although the CI includes the null value. CONCLUSIONS: Bacterial codetection was present in almost a third of children younger than 2 years requiring intubation and ICU admission for LRTI, but this was not associated with prolonged IMV. Further large studies are needed to evaluate if codetection is associated with shorter IMV duration.
dc.identifier.citationPediatric Critical Care Medicine, Vol. 25, N°7, (2024) p. 609-620.
dc.identifier.doihttps://doi.org/10.1097/pcc.0000000000003545
dc.identifier.issn1529-7535
dc.identifier.issne1947-3893
dc.identifier.orcidhttp://orcid.org/0000-0003-4763-074X
dc.identifier.urihttp://hdl.handle.net/20.500.12254/3787
dc.language.isoen
dc.publisherSociety of Critical Care Medicine​ and the World Federation of Pediatric Intensive and Critical Care Societies
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subjectChild
dc.subjectCoinfection
dc.subjectBronchiolitis
dc.subjectIntensive care units
dc.subjectRespiratory syncytial virus
dc.titlePrevalence of bacterial codetection and outcomes for infants intubated for respiratory infections
dc.typeArticle
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