臨床小児科: オープンアクセス
オープンアクセス

概要

The Incidence of Respiratory Syncytial Virus (RSV) Bronchiolitis and Concomitant Urinary Tract Infection (UTI) in Young Infants

Hanna S. Sahhar*, Samantha Houston, Luke Saunders, Wesley Gregory, David Redden, Sami E. Rishmawi

Aim: Respiratory Syncytial Virus (RSV) is the leading cause of bronchiolitis in infants, resulting in frequent hospital admissions for this age group. Concurrent bacterial infections significantly increase the risk of complications and mortality. Previous studies have explored the association between RSV infection and Urinary Tract Infection (UTI), but the evidence has been limited and contradictory. This study aims to clarify the relationship between RSV and UTI, facilitating informed clinical decision making and establishing the necessity for early intervention in this pediatric patient population. 
Objective: To investigate the potential correlation between RSV infection and concurrent UTI among hospitalized infants aged less than one year to assist with informed clinical decision making regarding optimal diagnostic and treatment approaches for pediatric patients diagnosed with RSV.
Methods: This single site, retrospective, observational study was conducted by reviewing 166 pediatric patients diagnosed and admitted for bronchiolitis caused by RSV. Data was gathered from the Spartanburg medical center Pediatric Intensive Care Unit (PICU) and general pediatrics ward from October 1st, 2016, to December 16th, 2021. Inclusion criteria consisted of all patients less than one year of age admitted with a diagnosis of RSV during the defined study period. Exact Chi-squared and Wilcoxon rank sum tests were used to compare the incidence of coinfection and associated risk factors.
Results: Based on the collected data, it was observed that among the 166 individuals included in the study, 3 (2 males and 1 female) had a positive urinalysis suggesting the presence of a co-existing urinary tract infection. Utilizing an exact 95% confidence interval, the estimated percentage of children with co-infection ranges from 0.37% to 5.19%. Statistical significance was not observed between co-infection and circumcision, fever, or prematurity. However, using a type 1 error rate of 0.10, perihilar infiltrates (p=0.058) were associated with co-infection, and noninvasive ventilation approached statistical significance (p=0.101). 
Conclusion: This study suggests no clinically significant rate of concomitant UTI in infants diagnosed with RSV bronchiolitis. The result of this study suggests avoiding the routine collection of urine studies in all patients under one year old who are admitted for RSV bronchiolitis. Workup for these infants should remain individualized, and UTI diagnosis should be pursued only when there is high clinical suspicion for co-infection. Additional research involving multiple sites and a larger sample size would be beneficial to further strengthen these conclusions.