Factors Associated with Adverse Outcomes among Febrile Young Infants with Invasive Bacterial Infections
| Autor: | Elana A. Feldman, Russell J. McCulloh, Christopher Woll, Sarah Shin, Derek J. Williams, Christopher M. Pruitt, Marie E. Wang, Catherine E. Lumb, Laura F. Sartori, Whitney L. Browning, Lise E. Nigrovic, Sanyukta Desai, David R. Peaper, Fran Balamuth, Elizabeth R. Alpern, Paul L. Aronson, Rianna C. Leazer, Christine E. Mitchell, Samir S. Shah, Adrienne G. DePorre, Veronika Shabanova, Sahar N. Rooholamini, Richard D. Marble, Mark I. Neuman |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Fever medicine.medical_treatment Bacteremia Logistic regression Article Young infants Meningitis Bacterial Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Sepsis 030225 pediatrics Internal medicine Epidemiology Infant Mortality medicine Humans Meningitis 030212 general & internal medicine Retrospective Studies Mechanical ventilation Evidence-Based Medicine business.industry Medical record Infant Newborn Infant Retrospective cohort study Bacterial Infections medicine.disease Anti-Bacterial Agents Pediatrics Perinatology and Child Health Female business |
| Zdroj: | The Journal of pediatrics. 204 |
| ISSN: | 1097-6833 |
| Popis: | OBJECTIVE: To determine factors associated with adverse outcomes among febrile young infants with invasive bacterial infections (IBI), i.e., bacteremia and/or bacterial meningitis. STUDY DESIGN: Multicenter, retrospective cohort study (July 2011 – June 2016) of febrile infants ≤60 days of age with pathogenic bacterial growth in blood and/or cerebrospinal fluid. Subjects were identified by query of local microbiology laboratory and/or electronic medical record systems, and clinical data were extracted by medical record review. Mixed-effect logistic regression was employed to determine clinical factors associated with 30-day adverse outcomes, which were defined as death, neurologic sequelae, mechanical ventilation, or vasoactive medication receipt. RESULTS: 350 infants met inclusion criteria; 279 (79.7%) with bacteremia without meningitis and 71(20.3%) with bacterial meningitis. Forty-two (12.0%) infants had a 30-day adverse outcome: 29/71 (40.8%) with bacterial meningitis vs. 13/279 (4.7%) with bacteremia without meningitis (36.2% difference, 95% CI 25.1% to 48.0%; P < .001). On adjusted analysis, bacterial meningitis (adjusted odds ratio [aOR] 16.3, 95% CI 6.5 to 41.0; P |
| Databáze: | OpenAIRE |
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