A Model for Predicting Risk of Serious Bacterial Infection in Febrile Infants Younger Than 3 Months of Age

Chen, Chun‐Jen; Lo, Yu-Fang; Huang, Miao-Chiu; Chung, Ruey-Lung; Tang, Ren-Bin; Wu, Keh-Gong

doi:10.1016/s1726-4901(09)70421-6

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…A causal relationship between neonatal jaundice and certain bacterial infections has been noticed, including urinary tract infections (UTIs) [ 4 5 ]. It was suggested that some Gram-negative bacteria can excrete some toxins called hemolysins that can destroy the red blood cells of the newborn and lead to unconjugated hyperbilirubinemia [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Significance of Urinary Tract Infection among Neonates Presenting with Unexplained Hyperbilirubinemia in Lebanon: A Retrospective Study

Harb,

Yassine,

Ghssein

et al. 2023

Infect Chemother

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Background Neonatal jaundice is commonly seen in term and preterm newly born babies. It could be either physiologic or secondary to multiple underlying pathologies like urinary tract infection (UTI). Our main objective was to confirm the relationship between neonatal jaundice without apparent cause like hemolysis and the presence of UTI. Materials and Methods We, retrospectively over a period extended from 2017 to 2020, included 496 babies admitted for elevated indirect hyperbilirubinemia for whom demographic, clinical, laboratory, and therapeutic data were collected through a detailed questionnaire. Results Our study included 496 neonates and showed a prevalence of UTI in 8.9% of neonates. The two most common microorganisms in urine culture were Escherichia coli (65.9%) and Klebsiella pneumoniae (25.0%). A multivariate logistic analysis showed that UTI was associated with male neonates (odds ratio [OR] = 2.366, 95% confidence interval [CI]: 1.173 – 4.774; P = 0.016), history of prenatal UTI (OR = 5.378, 95% CI: 2.369 – 12.209; P <0.001), poor feeding (OR = 3.687, 95% CI: 1.570 – 8.661; P = 0.003), and positive urine culture in catheter (OR = 2.704, 95% CI: 1.255 – 5.826; P = 0.011). The mean length of stay was higher in patients with positive UTI (Median = 216 hours) compared to patients with negative UTI (Median = 48 hours) ( P <0.001). Conclusion Neonatal sreening for UTI should be recommended whenever there is unexplaind early or prolonged hyperbilirubinemia with no evidence of alloimmune hemolysis or blood group incompatibility and to prevent the morbidity of urosepsis and congenital kidneys malformations.

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Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Significance of Urinary Tract Infection among Neonates Presenting with Unexplained Hyperbilirubinemia in Lebanon: A Retrospective Study

Harb,

Yassine,

Ghssein

et al. 2023

Infect Chemother

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“…1e3 Although it is mostly benign, some cases may have the possibility of having other diseases in combination. 4 There have been some reports regarding the relationship of idiopathic hyperbilirubinemia and bacterial infections, 5 such as urinary tract infection (UTI). 6 However, it is still not recommended to perform routine urinary tests in jaundiced infants for such infections.…”

Section: Introductionmentioning

confidence: 99%

Hyperbilirubinemia with urinary tract infection in infants younger than eight weeks old

Chen

Jeng

Soong

et al. 2011

Journal of the Chinese Medical Association

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“…These findings imply that male gender is a risk factor for the development of SBI in infants up to 90 days old. Other authors suggest a similar conclusion 1,22,[25][26][27] , so it is important to take gender into consideration during the evaluation of febrile infants. Although most studies found no link between gender and SBI 10,12,20,[28][29][30][31] , that discrepancy should be considered from the epidemiological and population point of view.…”

Section: Discussionmentioning

confidence: 65%

New prediction model for diagnosis of bacterial infection in febrile infants younger than 90 days

2017

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Due to non-specific clinical presentation in febrile infants, extensive laboratory testing is often carried out to distinguish simple viral disease from serious bacterial infection (SBI). Objective of this study was to compare efficacy of different biomarkers in early diagnosis of SBI in infants <90 days old. Also, we developed prediction models with whom it will be possible to diagnose SBI with more accuracy than with any biomarkers independently.Febrile <90-day-old infants hospitalized in 2-year-period at Department of Pediatrics, University Hospital Centre Split with suspicion of having SBI were included in this study. Retrospective cohort analysis of data acquired from medical records was performed. Out of 181 enrolled patients, SBI was confirmed in 70. Most common diagnosis was urinary tract infection (68.6%), followed by pneumonia (12.9%), sepsis (11.4%), gastroenterocolitis (5.7%) and meningitis (1.4%). Male gender was shown to be a risk factor for SBI in this population (p=0.008). White blood cell count (WBC), absolute neutrophil count (ANC) and C-reactive protein (CRP) were confirmed as the independent predictors of SBI, with CRP as the best one. Two prediction models built by combining biomarkers and clinical variables were selected as optimal with sensitivities of 74.3% and 75.7%, and specificities of 88.3% and 86%. Evidently, CRP is a more superior biomarker in diagnostics of SBI comparing to WBC and ANC. Prediction models were shown to be better in predicting SBI than independent biomarkers. Although both showed high sensitivity and specificity, their true strength should be determined using validation cohort.

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A Model for Predicting Risk of Serious Bacterial Infection in Febrile Infants Younger Than 3 Months of Age

Abstract: These findings suggest that sex, serum CRP concentration and spun urine WBC count can be used to accurately predict SBI in febrile infants aged less than 3 months of age.

Cited by 6 publications

References 17 publications

Prevalence and Clinical Significance of Urinary Tract Infection among Neonates Presenting with Unexplained Hyperbilirubinemia in Lebanon: A Retrospective Study

Prevalence and Clinical Significance of Urinary Tract Infection among Neonates Presenting with Unexplained Hyperbilirubinemia in Lebanon: A Retrospective Study

Hyperbilirubinemia with urinary tract infection in infants younger than eight weeks old

New prediction model for diagnosis of bacterial infection in febrile infants younger than 90 days

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