Prevalence of Invasive Bacterial Infection in Hypothermic Young Infants: A Multisite Study.

Autor: Raffaele JL; Department of Pediatrics, University of South Carolina School of Medicine Greenville, Prisma Health Children's Hospital-Upstate, Greenville, NC. Electronic address: Jennifer.raffaele@prismahealth.org., Sharma M; Department of Pediatrics, University of Alabama Heersink School of Medicine, Birmingham, AL., Berger S; Department of Pediatrics, University of Alabama Heersink School of Medicine, Birmingham, AL., Mitchell M; Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA., Lee C; Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA., Morrison J; Division of Pediatric Hospital Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, FL; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD., Prasad M; Division of Pediatric Hospital Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, FL., Combs MD; Department of Pediatrics, Keck School of Medicine of USC, Children's Hospital Los Angeles, Los Angeles, CA., Molas-Torreblanca K; Department of Pediatrics, Keck School of Medicine of USC, Children's Hospital Los Angeles, Los Angeles, CA., Wood JK; Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC., Van Meurs A; Department of Pediatrics, Oregon Health and Science University, Doernbecher Children's Hospital, Portland, OR., Westphal K; Division of Hospital Medicine, Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH., Sawani A; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH., Banker SL; Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY., Lee J; Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY., King C; Department of Psychology, Clemson University, Clemson, SC., Halvorson EE; Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC., Potisek NM; Department of Pediatrics, University of South Carolina School of Medicine Greenville, Prisma Health Children's Hospital-Upstate, Greenville, NC; Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2023 Jul; Vol. 258, pp. 113407. Date of Electronic Publication: 2023 Apr 05.
DOI: 10.1016/j.jpeds.2023.113407
Abstrakt: Objective: To determine the prevalence of bacteremia and meningitis (invasive bacterial infection [IBI]) in hypothermic young infants, and also to determine the prevalence of serious bacterial infections (SBI) and neonatal herpes simplex virus and to identify characteristics associated with IBI.
Study Design: We conducted a retrospective cohort study of infants ≤90 days of age who presented to 1 of 9 hospitals with historical or documented hypothermia (temperature ≤36.0°C) from September 1, 2017, to May 5, 2021. Infants were identified by billing codes or electronic medical record search of hypothermic temperatures. All charts were manually reviewed. Infants with hypothermia during birth hospitalization, and febrile infants were excluded. IBI was defined as positive blood culture and/or cerebrospinal fluid culture treated as a pathogenic organism, whereas SBI also included urinary tract infection. We used multivariable mixed-effects logistic regression to identify associations between exposure variables and IBI.
Results: Overall, 1098 young infants met the inclusion criteria. IBI prevalence was 2.1% (95% CI, 1.3-2.9) (bacteremia 1.8%; bacterial meningitis 0.5%). SBI prevalence was 4.4% (95% CI, 3.2-5.6), and neonatal herpes simplex virus prevalence was 1.3% (95% CI, 0.6-1.9). Significant associations were found between IBI and repeated temperature instability (OR, 4.9; 95% CI, 1.3-18.1), white blood cell count abnormalities (OR, 4.8; 95% CI, 1.8-13.1), and thrombocytopenia (OR, 5.0; 95% CI, 1.4-17.0).
Conclusions: IBI prevalence in hypothermic young infants is 2.1%. Further understanding of characteristics associated with IBI can guide the development decision tools for management of hypothermic young infants.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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