Document Detail

Concurrent bacterial infection and prolonged mechanical ventilation in infants with respiratory syncytial virus lower respiratory tract disease.
MedLine Citation:
PMID:  15803295     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To identify demographic, clinical, and laboratory variables predictive for a concurrent bacterial pulmonary infection in ventilated infants with respiratory syncytial virus (RSV) lower respiratory tract disease (LRTD) and investigate antimicrobial drug use. DESIGN AND SETTING: Retrospective, observational study in a 14-bed pediatric intensive care unit. PATIENTS: 82 infants younger than 1 year of age with a virologically confirmed RSV LRTD during 1996-2001, of whom 65 were mechanically ventilated. RESULTS: Microbiological data were available from 38 ventilated infants, 10 of whom had a positive blood culture (n=1) or endotracheal aspirate (n=9) obtained upon admission to the pediatric intensive care unit (PICU). Infants with a positive culture had a lower mean gestational age but were otherwise demographically comparable to those with negative culture results. Infants with a positive culture were ventilated 4 days longer. Indicators for a concurrent bacterial infection were comparable between ventilated and nonventilated infants. Antimicrobial drugs were used in 95.1% of infants (100% of ventilated infants) with a mean duration of 7.8+/-0.3 days. The moment of initiation and duration of antimicrobial drug treatment varied considerably. CONCLUSIONS: We observed in ventilated infants a low occurrence of concurrent bacterial pulmonary infection, but infants with positive cultures needed prolonged ventilatory support. Improvement in the diagnosis of a pulmonary bacterial infection is warranted to reduce the overuse of antimicrobial drugs among ventilated infants with RSV LRTD and to restrict these drugs to the proper patients.
Martin C J Kneyber; Heleen Blussé van Oud-Alblas; Margreet van Vliet; Cuno S P M Uiterwaal; Jan L L Kimpen; Adrianus J van Vught
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Publication Detail:
Type:  Journal Article     Date:  2005-04-01
Journal Detail:
Title:  Intensive care medicine     Volume:  31     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-06-13     Completed Date:  2006-01-27     Revised Date:  2006-03-16    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  680-5     Citation Subset:  IM    
Department of Pediatric Intensive Care, VU University Medical Center, P.O. Box 7507, 1007 MB Amsterdam, The Netherlands.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Bacteremia / epidemiology
Bacterial Infections / epidemiology*
Infant, Newborn
Logistic Models
Multivariate Analysis
Netherlands / epidemiology
Respiration, Artificial*
Respiratory Syncytial Virus Infections / epidemiology*,  therapy
Respiratory Tract Infections / epidemiology*,  etiology,  therapy
Retrospective Studies
Reg. No./Substance:
0/Anti-Bacterial Agents

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