Association of Cough Status With Bacterial Infections in Febrile Infants

Abstract

To examine the association between cough status and bacterial infections (BIs) to more accurately stratify risk and predict BIs in febrile infants.METHODS: A retrospective cohort study was performed by identifying all infants #60 days old with temperature $38°C at an urban pediatric emergency department from 2014 to 2016. The Rochester Risk model was used to stratify risk. Cough status (with or without) was the main covariate of interest. The primary outcome was a BI, including urinary tract infection, bacteremia, or meningitis. Analyses consisted of descriptive statistics, simple and multiple regression to compare the odds of BI on the basis of cough status, as well as x 2 statistics to compare the BI rates among high-risk infants with and without cough.RESULTS: Of 508 febrile infants #60 days old, 46 (9.1%) had a BI, 13 of which were either bacteremia or meningitis. There were no BIs among low-risk infants with a cough. The odds of BI increased progressively, peaking at 14.6 (95% confidence interval: 4.3-49.7) for high-risk infants without a cough. The adjusted odds of BI among infants with cough was 0.47 (95% confidence interval: 0.22-0.99). CONCLUSIONS:In our findings, an inverse relationship is demonstrated between presence of cough and odds of BI, suggesting that cough status may be a useful marker of viral infections in febrile infants. Considering that detecting cough status is noninvasive, inexpensive, and immediately available, it represents an attractive value-based risk factor to enhance current BI prediction models.

Derivation of a natural language processing algorithm to identify febrile infants

“…Thus, we sought to develop an algorithm to identify as many infants with fever as possible, regardless of severity or accompanying symptomatology, thereby creating the opportunity to investigate decision‐making processes and subsequent clinical outcomes. For example, for infants with viral illnesses (and/or respiratory symptoms) or infants with a reported fever rather than a documented fever in the ED, bacterial infection rates may be lower than other infants with fever, 27–29 but the risk is not zero. Clinicians must still weigh possible harms and benefits of diagnostic and management decisions with the likelihood of a bacterial infection.…”

Derivation of a clinical‐based model to detect invasive bacterial infections in febrile infants

“…Based on our previous findings and other studies, [5][6][7]9,10,[13][14][15][16][17] we selected 10 predictor variables a priori. Categorical predictor variables included sex, presence of a chronic medical condition (yes/no), appearance (well/ill/not documented), cough status (yes/ no/unknown), and urinary tract inflammation (yes/no/not ordered), defined as ≥5 white blood cells/high-power field of unspun urine or positive (≥trace) leukocyte esterase.…”

Composition characteristics of the gut microbiota in infants and young children of under 6 years old between Beijing and Japan

“…Moreover, human enteroviruses are commonly detected in the stool samples of infants. Although the enteroviruses mainly cause mild or asymptomatic infections in healthy children, it can also cause diarrhea (14). The infectious diseases are the cause of many deaths of children, especially among young children living in developing countries/ regions, due to poor sanitation, unsanitary drinking water, contaminated food or improper disposal of feces (15).…”