Prevalence of Bacterial Infection in Multisystem Inflammatory Syndrome in Children (Mis-C)

ABSTRACT

INTRODUCTION: Clinical presentation of MIS-C resembles bacterial infections and patients often receive empiric antibiotics. Bacterial infection prevalence has not been studied in MIS-C patients and data are limited to studies of MIS-C association with non-SARS-CoV-2 infections. We aim to study prevalence of bacterial infection in MIS-C patients to better understand this association and to limit unnecessary use of antibiotics. METHOD(S) Data from hospitalized patients with a diagnosis of MIS-C at Advocate Children's Hospital were retrospectively collected and analyzed. Primary objective was the prevalence of bacterial infection in MISC patients. Secondary objective was the pattern of antibiotics use. RESULT(S) Forty six patients were included. Most patients were male (63%), and majority were non-Hispanic (45%). Most patients received antibiotics for 2 days, and most frequently used antibiotic was ceftriaxone. Blood culture was positive in three cases (7.9%), and identified species was Staphylococcus (2) and E. coli (1). Urine culture was positive in seven cases and mostly identified as E. coli. All patients except one received IVIG and majority (92%) were treated with steroids. one third of our patients received inotropic or vasopressor supports during their hospitalizations. However, all patients had favorable outcomes and were discharged home in a stable condition. CONCLUSION(S) Children with MIS-C are less likely to have a bacterial infection. Our data suggest that antibiotics were used in the setting of pending blood and urine cultures and were discontinued when preliminary culture results became available. Further large-scale studies are needed to establish guidelines regarding antibiotics use in MIS-C patients.