Blood enterovirus polymerase chain reaction testing in young febrile infants

Pintos, Carla; Mintegi, Santiago; Benito, Javier; Aranzamendi, Maitane; Bonilla, Leire; Gómez, Borja

doi:10.1136/archdischild-2020-321077

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…11 First, we formed a main working group comprising five panelists with expertise in research on febrile infants. [12][13][14][15] They conducted a literature search and a reading of the most relevant papers published since 2010 on febrile infants, 2,7,[16][17][18][19][20][21][22][23] with special interest in the practice guidelines of the American Academy of Pediatrics. 7 Then, after this literature review, the group of panelists held two online meetings to draft an initial list of care standards for managing young infants, focusing on patients with fever without source.…”

Section: The Study Was Endorsed By the Spanish Paediatric Emergencymentioning

confidence: 99%

Multicentre Delphi study of physicians resulted in quality indicators for young infants with fever without source in emergency departments

et al. 2023

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AimManaging febrile infants has evolved without a generally accepted standard of care. We aimed to design quality indicators for managing infants ≤90 days old presenting to emergency departments (EDs) with fever without source.MethodsThis multicentre Delphi study was carried out by the Febrile Infant Study Group of the Spanish Paediatric Emergency Research Network, from March 2021 to November 2021, and included paediatric emergency physicians from 24 Spanish EDs. A list of care standards was produced, following an extensive literature review and the involvement of all parties. Indicators were essential if they were voted by four panelists and also received a score of ≥4 from at least 95% of the 24 investigators.ResultsWe established 20 indicators, including one related to having a protocol, two to triage, nine to diagnostic processes, six to treatment and two to disposition. The following indicators were considered essential: having an ED management protocol, performing urinalysis on every infant, obtaining a blood culture from every infant and administering antibiotics in the ED to any febrile infant who did not appear well.ConclusionThe Delphi method resulted in a comprehensive list of quality indicators for managing febrile young infants in Spanish EDs.

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Section: The Study Was Endorsed By the Spanish Paediatric Emergencymentioning

confidence: 99%

Multicentre Delphi study of physicians resulted in quality indicators for young infants with fever without source in emergency departments

et al. 2023

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Characteristics of oncology patients with fever and invasive bacterial infections diagnosed

Gomez,

Almarza,

López‐Almaraz

et al. 2024

Acta Paediatrica

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AimTo describe the characteristics of febrile oncology patients seen in the Paediatric Emergency Department and microbiological characteristics of the invasive bacterial infections (IBIs) diagnosed.MethodsWe conducted a prospective observational study of febrile oncology patients seen between 2016 and 2022. We divided haematologic cancers by the aggressiveness of the chemotherapy received at the time.ResultsWe included 418 episodes (272 haematologic cancers, 146 solid tumours). The median duration of fever was 2 h (interquartile range: 1–3) and 97.6% of patients were well‐appearing on arrival. We diagnosed 61 IBIs (14.6%), including six episodes of bacterial sepsis. One other episode was coded as sepsis without microbiological confirmation, yielding seven episodes overall (1.7%). Rates of IBI and sepsis were higher among patients with high‐risk haematologic cancers than those with low‐risk haematologic cancers or solid tumours (22.9%, 5.4% and 10.3%, p < 0.01; 3.4%, 0% and 0.7%, p = 0.06, respectively). Leading causes were S. epidermidis (42.6%) and E. coli (14.7%). Gram‐positive bacteria caused 67.2% of non‐septic IBIs and 50% of septic episodes.ConclusionMost febrile oncology patients are well‐appearing and present with a very short history of fever. Prevalence of IBI and sepsis and the main disease‐causing bacteria differ by cancer type and the presence of sepsis.

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Performance of blood enterovirus and parechovirus polymerase chain reaction testing in young febrile infants: a prospective multicentre observational study

Alonso-Cadenas,

Velasco,

Clerigué Arrieta

et al. 2024

Arch Dis Child

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ObjectivesTo analyse the performance of blood enterovirus and parechovirus PCR testing (ev-PCR) for invasive bacterial infection (IBI) (isolation of a single bacterial pathogen in a blood or cerebrospinal fluid culture) when evaluating well-appearing infants ≤90 days of age with fever without a source (FWS).MethodsWe describe the well-appearing infants ≤90 days of age with FWS and normal urine dipstick. We performed a prospective, observational multicentre study at five paediatric emergency departments between October 2020 and September 2023.ResultsA total of 656 infants were included, 22 (3.4%) of whom were diagnosed with an IBI (bacteraemia in all of them and associated with meningitis in four). The blood ev-PCR test was positive in 145 (22.1%) infants. One patient with positive blood ev-PCR was diagnosed with an IBI, accounting for 0.7% (95% CI 0.02 to 3.8) compared with 4.1% (95% CI 2.6 to 6.2) in those with a negative test (p=0.04). All four patients with bacterial meningitis had a negative blood ev-PCR result. Infants with a positive blood ev-PCR had a shorter hospital stay (median 3 days, IQR 2–4) compared with 4 days (IQR 2–6) for those with negative blood ev-PCR (p=0.02), as well as shorter duration of antibiotic treatment (median 2 days, IQR 0–4 vs 2.5 days, IQR 0–7, p=0.01).ConclusionsYoung febrile infants with a positive blood ev-PCR are at a low risk of having an IBI. Incorporating the blood ev-PCR test into clinical decision-making may help to reduce the duration of antibiotic treatments and length of hospital stay.

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Blood enterovirus polymerase chain reaction testing in young febrile infants

Cited by 5 publications

References 23 publications

Multicentre Delphi study of physicians resulted in quality indicators for young infants with fever without source in emergency departments

Multicentre Delphi study of physicians resulted in quality indicators for young infants with fever without source in emergency departments

Characteristics of oncology patients with fever and invasive bacterial infections diagnosed

Performance of blood enterovirus and parechovirus polymerase chain reaction testing in young febrile infants: a prospective multicentre observational study

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