The Epidemiology of Co-Infections in Febrile Children Younger than 5-Years-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

Background
Fever is one of the most common causes of children’s referral to pediatric emergency department (ED), and almost 20% of General ED referrals relate to febrile children. When it comes to febrile pediatrics patients, co-infection is a very important issue to discuss. 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 emergency department.
Materials and Methods: This cross-sectional study was carried out retrospectively with the enrollment of children younger than 5-years-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 months were studied (51.5% Girl).  The source of infection was unclear after using all of the 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 showed 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 seems that co-infections have been significantly increased in girls and in theage 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