Evidence map›Paper›PMID 36968962›Full record

ArticleOpen forum infectious diseases2023

Community-Onset Bacterial Coinfection in Children Critically Ill With Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

Kristin L Moffitt, Mari M Nakamura, Cameron C Young, Margaret M Newhams, Natasha B Halasa, J Nelson Reed, Julie C Fitzgerald, Philip C Spinella, Vijaya L Soma, Tracie C Walker and 27 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open forum infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024
    Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

37 authors.

Kristin L MoffittDivision of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-4581-7199
Mari M NakamuraDivision of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA.
Cameron C YoungDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-7323-4834
Margaret M NewhamsDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Natasha B HalasaDivision of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
J Nelson ReedDepartment of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA.
Julie C FitzgeraldDivision of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Philip C SpinellaDivision of Critical Care, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri, USA.
Vijaya L SomaDivision of Pediatric Infectious Diseases, Department of Pediatrics, New York University Grossman School of Medicine, Hassenfeld Children's Hospital, New York, New York, USA.
Tracie C WalkerDepartment of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina, USA.
Laura L LoftisDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Aline B MadduxDepartment of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.
Michele KongDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Courtney M RowanDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA.
Charlotte V HobbsDepartment of Pediatrics, Division of Disease, University of Mississippi Medical Center, Jackson, Mississippi, USA.ORCID https://orcid.org/0000-0003-4829-0791
Jennifer E SchusterDivision of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.
Becky J RiggsDivision of Pediatric Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Gwenn E McLaughlinDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.
Kelly N MichelsonDivision of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Mark W HallDivision of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
Christopher J BabbittMiller Children's and Women's Hospital of Long Beach, Long Beach, California, USA.
Natalie Z CvijanovichDivision of Critical Care Medicine, University of California, San Francisco Benioff Children's Hospital, Oakland, California, USA.
Matt S ZinterSchool of Medicine, Department of Pediatrics, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, California, USA.
Mia MaamariDepartment of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Health Medical Center Dallas, Dallas, Texas, USA.
Adam J SchwarzDivision of Critical Care Medicine, Children's Hospital Orange County, Orange, California, USA.
Aalok R SinghPediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
Heidi R FloriDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan, USA.
Shira J GertzDivision of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA.
Mary A StaatDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
John S GiulianoDepartment of Pediatrics, Division of Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA.
Saul R HymesDivision of Pediatric Infectious Diseases, Stony Brook Children's Hospital, Renaissance School of Medicine, Stony Brook, New York, USA.
Katharine N ClouserDepartment of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA.
John McGuireDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital and the University of Washington, Seattle, Washington, USA.
Christopher L CarrollDivision of Critical Care, Connecticut Children's, Hartford, Connecticut, USA.
Neal J ThomasDepartment of Pediatrics, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
Emily R LevyDivisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Adrienne G RandolphDepartment of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-3084-3071

Funding

Pediatric septic acute kidney injury: personalizing antibiotic dosing through understanding acute kidney injury risk factors and biomarker profilesK23DK119463 · NIDDK · CHILDREN'S HOSP OF PHILADELPHIA · PI FITZGERALD, JULIE C. HOLLOWS · 2020 to 2024
$810k
NIDDK NIH HHS K23 DK119463
6 · The paper itself

Abstract

Background: Community-onset bacterial coinfection in adults hospitalized with coronavirus disease 2019 (COVID-19) is reportedly uncommon, though empiric antibiotic use has been high. However, data regarding empiric antibiotic use and bacterial coinfection in children with critical illness from COVID-19 are scarce. Methods: We evaluated children and adolescents aged <19 years admitted to a pediatric intensive care or high-acuity unit for COVID-19 between March and December 2020. Based on qualifying microbiology results from the first 3 days of admission, we adjudicated whether patients had community-onset bacterial coinfection. We compared demographic and clinical characteristics of those who did and did not (1) receive antibiotics and (2) have bacterial coinfection early in admission. Using Poisson regression models, we assessed factors associated with these outcomes. Results: Of the 532 patients, 63.3% received empiric antibiotics, but only 7.1% had bacterial coinfection, and only 3.0% had respiratory bacterial coinfection. In multivariable analyses, empiric antibiotics were more likely to be prescribed for immunocompromised patients (adjusted relative risk [aRR], 1.34 [95% confidence interval {CI}, 1.01-1.79]), those requiring any respiratory support except mechanical ventilation (aRR, 1.41 [95% CI, 1.05-1.90]), or those requiring invasive mechanical ventilation (aRR, 1.83 [95% CI, 1.36-2.47]) (compared with no respiratory support). The presence of a pulmonary comorbidity other than asthma (aRR, 2.31 [95% CI, 1.15-4.62]) was associated with bacterial coinfection. Conclusions: Community-onset bacterial coinfection in children with critical COVID-19 is infrequent, but empiric antibiotics are commonly prescribed. These findings inform antimicrobial use and support rapid de-escalation when evaluation shows coinfection is unlikely.

Indexed as

antimicrobial stewardshipbacterial coinfectionpediatric COVID-19pneumoniaSARS-CoV-2

Identifiers

PMID36968962
PMCPMC10034750

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.