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BACKGROUND: Hypothermic young infants presenting to the Emergency Department (ED) are at risk for serious bacterial infections (SBI), however there is no consensus temperature to prompt evaluation for SBI among these children. We sought to statistically derive a temperature threshold to guide detection of SBI in hypothermic young infants presenting to the ED. METHODS: We performed a cross-sectional study of infants ≤90 days old presenting to four academic pediatric EDs from January 2015 through December 2019 with a rectal temperature of ≤36.4°C. Our primary outcomes were SBI, defined as urinary tract infection (UTI), bacteremia, and/or bacterial meningitis, and invasive bacterial infections (IBI, limited to bacteremia and/or bacterial meningitis). We constructed receiver operating characteristic (ROC) curves to evaluate an optimally derived cutpoint for minimum ED temperature and presence of SBI or IBI. RESULTS: We included 3,376 infants, of whom SBI were found in 62 (1.8%) and IBI in 16 (0.5%). The most common infection identified was Escherichia coli UTI. Overall cohort minimum median temperature was 36.2°C (IQR 36.0–36.4°C). Patients with SBI and IBI had lower median temperatures, 35.8°C (IQR 35.8–36.3°C) and 35.4°C (IQR 35.7–36.3°C) respectively, compared to those without corresponding infections (both P |
