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Epidemiology of Bacteremia in Febrile Infants Aged 60 Days and Younger
- Powell, Elizabeth C;
- Mahajan, Prashant V;
- Roosevelt, Genie;
- Hoyle, John D;
- Gattu, Rajender;
- Cruz, Andrea T;
- Rogers, Alexander J;
- Atabaki, Shireen M;
- Jaffe, David M;
- Casper, T Charles;
- Ramilo, Octavio;
- Kuppermann, Nathan;
- Network, Febrile Infant Working Group of the Pediatric Emergency Care Applied Research;
- Powell, Elizabeth C;
- Levine, Deborah A;
- Tunik, Michael G;
- Nigrovic, Lise E;
- Roosevelt, Genie;
- Mahajan, Prashant;
- Alpern, Elizabeth R;
- Vitale, Melissa;
- Browne, Lorin;
- Saunders, Mary;
- Atabaki, Shireen M;
- Ruddy, Richard M;
- Linakis, James G;
- Hoyle, John D;
- Borgialli, Dominic;
- Blumberg, Stephen;
- Crain, Ellen F;
- Anders, Jennifer;
- Bonsu, Bema;
- Cohen, Daniel M;
- Bennett, Jonathan E;
- Dayan, Peter S;
- Greenberg, Richard;
- Jaffe, David M;
- Muenzer, Jared;
- Cruz, Andrea T;
- Macias, Charles;
- Kuppermann, Nathan;
- Tzimenatos, Leah;
- Gattu, Rajender;
- Rogers, Alexander J;
- Brayer, Anne;
- Lillis, Kathleen
Published Web Location
https://doi.org/10.1016/j.annemergmed.2017.07.488Abstract
Study objective
To describe the current epidemiology of bacteremia in febrile infants 60 days of age and younger in the Pediatric Emergency Care Applied Research Network (PECARN).Methods
We conducted a planned secondary analysis of a prospective observational study of febrile infants 60 days of age and younger presenting to any of 26 PECARN emergency departments (2008 to 2013) who had blood cultures obtained. We excluded infants with significant comorbidities or critically ill appearance. The primary outcome was prevalence of bacteremia.Results
Of 7,335 screened infants, 4,778 (65.1%) had blood cultures and were enrolled. Of these patients, 84 had bacteremia (1.8%; 95% confidence interval [CI] 1.4% to 2.2%). The prevalence of bacteremia in infants aged 28 days or younger (47/1,515) was 3.1% (95% CI 2.3% to 4.1%); in infants aged 29 to 60 days (37/3,246), 1.1% (95% CI 0.8% to 1.6%). Prevalence differed by week of age for infants 28 days of age and younger (0 to 7 days: 4/156, 2.6%; 8 to 14 days: 19/356, 5.3%; 15 to 21 days: 15/449, 3.3%; and 22 to 28 days: 9/554, 1.6%). The most common pathogens were Escherichia coli (39.3%; 95% CI 29.5% to 50.0%) and group B streptococcus (23.8%; 95% CI 16.0% to 33.9%). Bacterial meningitis occurred in 19 of 1,515 infants 28 days of age and younger (1.3%; 95% CI 0.8% to 2.0%) and 5 of 3,246 infants aged 29 to 60 days (0.2%; 95% CI 0.1% to 0.4%). Of 84 infants with bacteremia, 36 (42.9%; 95% CI 32.8% to 53.5%) had urinary tract infections (E coli 83%); 11 (13.1%; 95% CI 7.5% to 21.9%) had bacterial meningitis.Conclusion
The prevalence of bacteremia and meningitis among febrile infants 28 days of age and younger is high and exceeds that observed in infants aged 29 to 60 days. E coli and group B streptococcus are the most common bacterial pathogens.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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