Predictors of bacteremia in febrile infants under 3 months old in the pediatric emergency department

BMC Pediatrics

Research

Han-Ping Wu¹  Chun-Yu Chen²  Wen-Ya Lin³  Bei-Cyuan Guo⁴  Yin-Ting Chen⁵  Yu-Jun Chang⁶ 

[1] College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Pediatrics, Chiayi Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd, Puzi City, Taiwan;Department of Emergency Medicine, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan;Department of Pediatric Emergency Medicine, Department of Pediatrics, Taichung Veteran General Hospital, Taichung, Taiwan;Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan;Division of Neonatology, Department of Pediatrics, Children Hospital, China Medical University, Taichung, Taiwan;Laboratory of Epidemiology and Biostastics, Changhua Christian Hospital, Changhua, Taiwan;

关键词: Infant;    Fever;    Bacteremia;    Emergency department;   

DOI  :  10.1186/s12887-023-04271-z

 received in 2023-05-18, accepted in 2023-08-24,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionFever may serve as the primary indicator of underlying infection in children admitted to the pediatric emergency department (PED), especially in high-risk young infants. This study aimed to identify early clinical factors that could help predict bacteremia in young febrile infants.MethodsThe study included infants under 90 days of age who were admitted to the PED due to fever. Patients were divided into two groups based on the presence or absence of bacteremia and further divided into three age groups: (1) less than 30 days, (2) 30 to 59 days, and (3) 60 to 90 days. Several clinical and laboratory variables were analyzed, and logistic regression and receiver operating characteristic (ROC) analyses were used to identify potential risk factors associated with bacteremia in young febrile infants.ResultsA total of 498 febrile infants were included, of whom 6.4% were diagnosed with bacteremia. The bacteremia group had a higher body temperature (BT) at triage, especially in neonates, higher pulse rates at triage, longer fever subsidence time, longer hospital stays, higher neutrophil counts, and higher C-reactive protein (CRP) levels than those of the non-bacteremia group. ROC analysis showed that the best cut-off values for predicting bacteremia in infants with pyrexia were a BT of 38.7 °C, neutrophil count of 57.9%, and CRP concentration of 53.8 mg/L.ConclusionsA higher BT at triage, increased total neutrophil count, and elevated CRP levels may be useful for identifying bacteremia in young febrile infants admitted to the PED.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023