Febrile infant update

Dorney, Kate; Bachur, Richard G.

doi:10.1097/mop.0000000000000492

Cited by 23 publications

(24 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are several reports that certain bacteria such as Proteus may not result in pyuria. 22) Urinalysis (positive was defined as >5 WBC/HPF, positive leukocyte esterase, or positive nitrite) was positive in only 69% of samples with positive urine cultures in a retrospective review of children aged 2 months through 2 years presenting with fever. 23) Therefore, it is necessary to find an alternative reliable marker for the early diagnosis of UTI in febrile infants.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection

et al. 2018

View full text Add to dashboard Cite

PurposeThe aim of this study was to evaluate the diagnostic accuracy of urinary biomarkers, such as neutrophil gelatinase-associated lipocalin (uNGAL) and β-2 microglobulin (uB2MG), in early detection of urinary tract infection (UTI) in infants aged <3 months with fever.MethodsA total of 422 infants aged <3 months (male:female=267:155; mean age, 56.4 days), who were admitted for fever, were retrospectively included in this study. We compared uNGAL and uB2MG between the UTI and non-UTI groups at the time of admission. The sensitivity, specificity, accuracy, and area under the curve (AUC) of uNGAL and uB2MG for use in diagnosing UTI were assessed.ResultsAmong 422 patients, 102 (24.2%) were diagnosed with UTI. Levels of uNGAL were higher in the UTI group than in the non-UTI group (366.6 ng/mL vs. 26.9 ng/mL, P<0.001). Levels of uB2MG were not different between the 2 groups. Multivariate analysis revealed that uNGAL was an independent predictive factor for UTI (P=0.033). The sensitivity, specificity, and accuracy were 90.2%, 92.5%, and 91.9% for uNGAL, and 48.0%, 43.8%, and 44.8% for uB2MG, respectively. AUC of uNGAL was 0.942 and that of uB2MG was 0.407.ConclusionAccuracy of uNGAL in the diagnosis of UTI is high in febrile infants aged <3 months. uNGAL can help in the early diagnosis and treatment of UTI in infants.

show abstract

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection

et al. 2018

View full text Add to dashboard Cite

show abstract

“…E coli is the most common pathogen involved in invasive bacterial infections in young febrile infants 3,5 . Many of these are associated with UTI, which is the most common serious bacterial infection in young febrile infants 12 . Young febrile infants with UTI are more prone to have associated bacteraemia 12 .…”

Section: Discussionmentioning

confidence: 99%

“…3,5 Many of these are associated with UTI, which is the most common serious bacterial infection in young febrile infants. 12 Young febrile infants with UTI are more prone to have associated bacteraemia. 12 Around 5% of febrile infants <3 months of age with UTI have an associated bacteraemia, with the highest risk in infants <28 days.…”

Section: Discussionmentioning

confidence: 99%

“…12 Young febrile infants with UTI are more prone to have associated bacteraemia. 12 Around 5% of febrile infants <3 months of age with UTI have an associated bacteraemia, with the highest risk in infants <28 days. 13 Traditionally, it has been recommended to hospitalise young febrile infants with suspected UTI due to the concern of acute adverse events and for missing concomitant bacteraemia.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Paediatric Escherichia coli bacteraemia presentations and high‐risk factors in the emergency department

et al. 2020

View full text Add to dashboard Cite

Aim Escherichia coli (E coli) is a known cause of paediatric bacteraemia. The main objective was to characterise the emergency department (ED) presentations of paediatric E coli bacteraemia and secondarily to identify those related to greater severity. Methods This was a sub‐study of a multicentre cross‐sectional prospective registry including all with E coli bacteraemia episodes between 2011 and 2016. We used multiple correspondence and cluster analysis to identify different patterns. Results We included 291 patients and 43 met criteria for severe disease (14.3%, 95% confidence interval 11.2‐19.3). We identified four types of paediatric E coli bacteraemia presentations. Two (178 patients, 61.2%) were related to well‐appearing previously healthy infants with associated urinary tract infection (UTI). Well‐appearing children older than 12 months old with underlying disease (n = 60, 20.6%) and non‐well‐appearing children of different ages (n = 53, 18.2%) corresponded to the other two types; these had associated UTI infrequently and higher severity rate (15% and 50.9%, respectively, higher when compared with the two previous types, P < .01), including the two patients who died. Conclusion There were four different types of ED paediatric E coli bacteraemia presentations with different severity. Febrile young children with associated UTI showed the best outcome.

show abstract

“…Neonates age ≤28 days old, and particularly ≤21 days old, had the greatest risk of readmission. Younger infants are known to be at higher risk of serious bacterial infection due to their relatively immature immune responses, while clinical signs may be more subtle in this population 9,10 . Currently, some risk‐stratification guidelines allow well‐appearing neonates ≤21 days old to be managed as outpatients, 17 while others consider all neonates ≤28 days to be at high risk of serious bacterial infection even if well‐appearing and without other risk factors 9,10 .…”

Section: Discussionmentioning

confidence: 99%

Predictors of hospital readmission in infants less than 3 months old

Mace

Barnes

Blyth

et al. 2020

J Paediatrics Child Health

View full text Add to dashboard Cite

Aim To examine rates and predictors of 7‐day readmission in infants hospitalised before 3 months of age with infectious and non‐infectious conditions. Methods Retrospective population‐based data‐linkage study of 121 854 infants from a 5‐year metropolitan birth cohort (2008–2012). Cox proportional hazard models were used to examine associations between infant and maternal factors with 7‐day readmission. Results A total of 11 669 (9.6%) infants were hospitalised at least once by 3 months of age (median 23 days old, 56% male) with 12 602 total index hospitalisations. Infection‐related conditions accounted for 29.4% (n = 3705). Readmission within 7 days occurred after 4.8% of all index hospitalisations and 5.4% of infection‐related hospitalisations. Age ≤21 days was the strongest readmission risk factor (hazard ratio 7.7 (95% confidence interval 4.7–12.7) compared to infants 61–90 days old). Other risk factors included shorter index hospitalisations, younger maternal age and multi‐gravidity. Conclusion Hospitalisations and readmissions occur for many young infants. Risk factors for readmission should inform risk‐based management guidelines.

show abstract

Febrile infant update

Abstract: The majority of febrile infants with an SBI will have a UTI but the diagnosis of invasive bacterial infection in infants continues to be challenging. The use of procalcitonin and CRP as biomarkers in prediction algorithms facilitates identification of low-risk infants.

Cited by 23 publications

References 46 publications

Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection

Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection

Paediatric Escherichia coli bacteraemia presentations and high‐risk factors in the emergency department

Predictors of hospital readmission in infants less than 3 months old

Contact Info

Product

Resources

About