Introduction
Material and methods
Study design
Data collection
Outcomes
Statistical analysis
Results
Patient characteristics
Children (N = 284) | Adults (N = 232) | |
---|---|---|
Age (years) | 1.3 [0.6–3.0] | 64.5 [52–75] |
Male (sex) | 167 (59) | 131 (57) |
Presence of comorbidity | 125 (44) | 199 (86) |
Ill-appearing | 113 (40) | 114 (53) |
Maximum temperature (°C) | 39.2 (0.9) | 38.6 (1.0) |
Duration of symptoms (days) | 3 (2) | 4 (2) |
Hospital admission | 208 (75) | 217 (94) |
Hospitalisation duration, days | 4 [3–8] | 5 [3–8] |
CRP (mg/L) at admission | 16 [4–43] | 34 [9–136] |
Disease severity | ||
Oxygen saturation (%) | 95 [92–98] | 94 [91–96] |
Needed mechanical ventilation | 31 (11) | 3 (1) |
Deaths | 1 (1) | 3 (1) |
Admission site | ||
Secondary care centre | 198 (70) | 173 (75) |
Tertiary care centre | 47 (16) | 53 (23) |
ICU | 39 (14) | 6 (2) |
Country | ||
The Netherlands | 136 (48) | 131 (56) |
Israel | 148 (52) | 101 (44) |
Clinical syndrome | ||
COPD/asthma exacerbation | 4 (1) | 45 (19) |
LRTI | 150 (53) | 172 (74) |
URTI | 130 (46) | 15 (7) |
Patient outcomes
a. | ||||
Paediatric | Viral N = 209 | Bacterial N = 75 | ||
Viruses detecteda | Antibiotic usec | Viruses detected | Antibiotic use | |
Adenovirus | 28 | 12(43) | 2 | 2(100) |
Bocavirus | 22 | 7(32) | 5 | 5(100) |
Influenza virus | 30 | 10(33) | 6 | 6(100) |
Rhinovirus | 45 | 16(36) | 17 | 16(94) |
RSV | 75 | 32(43) | 23 | 22(96) |
Otherb | 26 | 11(42) | 8 | 8(100) |
b. | ||||
Adult | Viral N = 89 | Bacterial N = 143 | ||
Viruses detected | Antibiotic usec | Viruses detected | Antibiotic use | |
Influenza virus | 35 | 30(86) | 17 | 16(94) |
Rhinovirus | 16 | 12(75) | 6 | 6(100) |
RSV | 14 | 13(93) | 4 | 4(100) |
Otherd | 11 | 10(91) | 8 | 8(100) |
a. Paediatric cohort | Viral N = 209 | Bacterial N = 75 | p value |
Age (years) | 1.2 [0.6–2.8] | 1.3 [0.5–5.8] | 0.102 |
Male sex | 119 (57) | 48 (64) | 0.122 |
Presence of comorbidity | 86 (41) | 39 (52) | 0.104 |
Ill-appearing | 75 (36) | 38 (51) | 0.059 |
Maximum temperature (°C) | 39.1 (0.9) | 39.3 (0.9) | 0.150 |
Duration of symptoms (days) | 3 (2) | 3 (2) | 0.497 |
Hospital admission | 144 (70) | 64 (91) | < 0.0001 |
Hospitalisation duration (days) | 4 [3–6] | 4 [2–16] | 0.050 |
CRP (mg/L) at admission | 13 [4–38] | 22 [6–131] | 0.001 |
Oxygen saturation (%) | 96 [92–98] | 95 [91–98] | 0.523 |
Need mechanical ventilation | 12 (6) | 19 (25) | < 0.0001 |
Admission site | < 0.0001 | ||
Secondary care centre | 152 (73) | 46 (61) | |
Tertiary care centre | 40 (19) | 7 (9) | |
ICU | 17 (8) | 22 (29) | |
Country | 0.291 | ||
The Netherlands | 104 (50) | 32 (43) | |
Israel | 105 (50) | 43(57) | |
Clinical syndrome | < 0.0001 | ||
Asthma exacerbation | 4 (2) | 0 (0) | |
LRTI | 110 (53) | 55 (73) | |
URTI | 95 (45) | 20 (27) | |
b. Adult cohort | Viral N = 89 | Bacterial N = 143 | p value |
Age (years) | 61 [46–72] | 67 [53–75] | 0.061 |
Male sex | 46 (52) | 85 (59) | 0.247 |
Presence of comorbidity | 79 (89) | 120 (84) | 0.304 |
Ill-appearing | 38 (43) | 76 (59) | 0.023 |
Maximum temperature (°C) | 38.3 (0.9) | 38.7 (1.0) | 0.015 |
Duration of symptoms (days) | 4 (2) | 4 (3) | 0.495 |
Hospital admission | 79 (89) | 138 (97) | 0.009 |
Hospitalisation duration (days) | 4 [3–6] | 6 [3–9] | 0.010 |
CRP (mg/L) at admission | 14 [4–43] | 67 [16–193] | < 0.0001 |
Oxygen saturation (%) | 95 [91–96] | 94 [92–97] | 0.779 |
Needed mechanical ventilation | 2 (2) | 1 (1) | 0.310 |
Admission site | 0.007 | ||
Secondary care centre | 71 (80) | 102 (71) | |
Tertiary care centre | 13 (15) | 40 (28) | |
ICU | 5 (5) | 1 (1) | |
Country | 0.376 | ||
The Netherlands | 47 (53) | 84 (59) | |
Israel | 42 (47) | 59 (41) | |
Clinical syndrome | 0.001 | ||
COPD/asthma exacerbation | 23 (26) | 22 (15) | |
LRTI | 55 (62) | 117 (82) | |
URTI | 11 (12) | 4 (3) |
Antibiotic usage
a. | AB+ (N = 77) | AB− (N = 132) | p value |
Age (years) | 1.0 [0.5–2.7] | 1.2 [0.6–2.8] | 0.945 |
Male sex | 42 (55) | 77 (58) | 0.594 |
Presence of comorbidity | 24 (31) | 62 (47) | 0.025 |
Ill-appearing | 30 (39) | 45 (35) | 0.473 |
Maximum temperature (°C) | 39.2 (0.9) | 39.1 (0.8) | 0.479 |
Duration of symptoms (days) | 3 (2) | 3 (2) | 0.352 |
Hospital admission | 60(79) | 84 (65) | 0.030 |
Hospitalisation duration (days) | 5 [3–9] | 3 [2–4] | < 0.001 |
CRP (mg/L) at admission | 14 [3–32] | 10 [3–26] | 0.294 |
Disease severity | |||
Oxygen saturation, % | 95 [88–97] | 97 [93–99] | 0.051 |
Needed mechanical ventilation | 9 (12) | 3 (2) | 0.005 |
Death | 0 (0) | 0 (0) | NA |
Admission site | 0.032 | ||
Secondary care centre | 50 (65) | 102 (77) | |
Tertiary care centre | 16 (21) | 24 (18) | |
ICU | 11 (14) | 6 (5) | |
Country | 0.070 | ||
The Netherlands | 32 (42) | 72 (55) | |
Israel | 45 (58) | 60 (45) | |
Clinical syndrome | 0.001 | ||
COPD/asthma exacerbation | 0 (0) | 4 (3) | |
LRTI | 48 (62) | 47 (36) | |
URTI | 29 (38) | 81 (61) | |
b. | AB+ (n = 74) | AB− (n = 15) | p value |
Age (years) | 64 [47–75] | 56 [51–60] | 0.086 |
Male sex | 42 (57) | 4 (27) | 0.033 |
Presence of comorbidity | 66 (89) | 13 (87) | 0.778 |
Ill-appearing | 34 (47) | 4 (27) | 0.156 |
Maximum temperature (°C) | 38.5 (0.9) | 37.8 (0.6) | 0.004 |
Duration of symptoms (days) | 4 (2) | 3 (2) | 0.478 |
Hospital admission | 66 (89) | 13 (87) | 0.778 |
Hospitalisation duration (days) | 4 [3–6] | 4 [2–7] | 0.805 |
CRP (mg/L) at admission | 15 [5–45] | 7 [3–35] | 0.332 |
Disease severity | |||
Oxygen saturation (%) | 95 [91–96] | 95 [91–98] | 0.317 |
Needed mechanical ventilation | 2 (3) | 0 (0) | 0.520 |
Death | 1 (1) | 0 (0) | 0.651 |
Admission site | 0.234 | ||
Secondary care centre | 60 (81) | 11 (73) | |
Tertiary care centre | 9 (12) | 4 (27) | |
ICU | 5 (7) | 0 (0) | |
Country | 0.021 | ||
The Netherlands | 35 (47) | 12 (80) | |
Israel | 39 (53) | 3 (20) | |
Clinical syndrome | 0.003 | ||
COPD/asthma exacerbation | 14 (19) | 9 (60) | |
LRTI | 51 (69) | 4 (27) | |
URTI | 9 (12) | 2 (13) |