학술논문
Serious Bacterial Infections in Young Febrile Infants With Positive Urinalysis Results.
Document Type
article
Author
Cruz, Andrea; Vitale, Melissa; Powell, Elizabeth; Leetch, Aaron; Pickett, Michelle; Brayer, Anne; Nigrovic, Lise; Dayan, Peter; Atabaki, Shireen; Ruddy, Richard; Rogers, Alexander; Greenberg, Richard; Alpern, Elizabeth; Tunik, Michael; Saunders, Mary; Muenzer, Jared; Levine, Deborah; Hoyle, John; Lillis, Kathleen; Gattu, Rajender; Crain, Ellen; Borgialli, Dominic; Bonsu, Bema; Blumberg, Stephen; Anders, Jennifer; Roosevelt, Genie; Browne, Lorin; Cohen, Daniel; Linakis, James; Jaffe, David; Bennett, Jonathan; Schnadower, David; Park, Grace; Mistry, Rakesh; Glissmeyer, Eric; Cator, Allison; Bogie, Amanda; Quayle, Kimberly; Ellison, Angela; Balamuth, Fran; Richards, Rachel; Ramilo, Octavio; Mahajan, Prashant; VanBuren, John; Kuppermann, Nathan; Tzimenatos, Leah
Source
Pediatrics. 150(4)
Subject
Language
Abstract
UNLABELLED: It is unknown whether febrile infants 29 to 60 days old with positive urinalysis results require routine lumbar punctures for evaluation of bacterial meningitis. OBJECTIVE: To determine the prevalence of bacteremia and/or bacterial meningitis in febrile infants ≤60 days of age with positive urinalysis (UA) results. METHODS: Secondary analysis of a prospective observational study of noncritical febrile infants ≤60 days between 2011 and 2019 conducted in the Pediatric Emergency Care Applied Research Network emergency departments. Participants had temperatures ≥38°C and were evaluated with blood cultures and had UAs available for analysis. We report the prevalence of bacteremia and bacterial meningitis in those with and without positive UA results. RESULTS: Among 7180 infants, 1090 (15.2%) had positive UA results. The risk of bacteremia was higher in those with positive versus negative UA results (63/1090 [5.8%] vs 69/6090 [1.1%], difference 4.7% [3.3% to 6.1%]). There was no difference in the prevalence of bacterial meningitis in infants ≤28 days of age with positive versus negative UA results (∼1% in both groups). However, among 697 infants aged 29 to 60 days with positive UA results, there were no cases of bacterial meningitis in comparison to 9 of 4153 with negative UA results (0.2%, difference -0.2% [-0.4% to -0.1%]). In addition, there were no cases of bacteremia and/or bacterial meningitis in the 148 infants ≤60 days of age with positive UA results who had the Pediatric Emergency Care Applied Research Network low-risk blood thresholds of absolute neutrophil count