The epidemiology of co-infections in febrile children younger than 5-year-old in emergency department; a cross-sectional hospital-based study

Authors

1 Pediatric Emergency Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.

2 School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Department of Emergency Medicine, Shohaday-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: : Fever is one of the most common causes of children referral to pediatric emergency department (ED) and almost 20% of general ED referrals is relating to febrile children. When it comes to febrile pediatrics patients, co-infection is a very important issue to discuss about. This topic has been considered in current literature so, we considered to examine the epidemiology of these co-infections in febrile children younger than 5 years in emergent department.
Methods: This cross-sectional study was carried out retrospectively with the enrollment of children younger than 5-year-old (accessible sampling) in the emergency department of Mofid Hospital, Tehran, Iran, during November 2017 to December 2018.  After designing and completing a check list.  
Results:
 Totally, 388 patients with the mean age of 25.4 ± 12.4 (range = newborn to 5 years) were studied (51.5% Girl).  The source of infection was unclear after using all of diagnostic tools in 27.5% of cases. Based on the findings fever-associated diarrhea (132 patients, 46.9%) and cellulitis (1 patient, 0.4%) were the most and least frequent source of infections, respectively. The co-incidence of different source of infections shows that  the most frequent co-infections were sepsis and UTI; otitis and UTI; pneumonia and UTI; pneumonia and URI; and sepsis and otitis.
Conclusion:
It seemed that co-infections have been significantly increased in girls and age range of 6-36 months.The most and least prevalent infections were fever-associated diarrhea and cellulitis among the patients with at least one type of infection. The co-incidence of different source of infection showed that the most frequent co-infections were sepsis and UTI; otitis and UTI; pneumonia and UTI; pneumonia and URI; and sepsis and otitis.

Keywords