CAN VIRUS LABORATORY HELP IN THE MANAGEMENT OF INFANTS HOSPITALIZED FOR SUSPECTED SEPSIS?

Abstract

Young infants hospitalized with signs of sepsis are generally evaluated and treated for bacterial diseases, but only a few are culture positive. The possible impact of virus diagnosis in the routine treatment of such infants was not previously studied. We studied prospectively from July 1, 1982 to June 30, 1984 233 previously healthy infants < 3-months-old hospitalized for suspected sepsis in order to determine: 1) presence of bacterial and viral pathogens; 2) the ability of the virus laboratory to provide the appropriate diagnosis within 72 hrs from admission. Bacterial infections were found in 23 infants (bacteremia - 5, bacteremia + meningitis - 4, UTI - 4, Bacterial gastroenteritis - 4, soft tissue/skeletal infect. - 6). Virus was detected in 138/233 (65%) infants (positive culture - 132, IFA - 34, CIE - 3). The most commonly detected viruses during the summer were enteroviruses (EV) - 63% of infants. During the winter, the most common viruses were respiratory syncytial virus and influenza A virus - 65% of the infants. Of the EV infected infants virus was isolated from blood, CSF or both in 63%. Virus was detected in 33% of the virus-positive infants within 24 hours of admission, 56% within 48 h and 64% within 72 h. Viral infections cause most hospitalization for suspected sepsis in infants < 3-months-old, and can often be detected early enough to influence management decisions.

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