Incidence of Occult Bacteremia Among Highly Febrile Young Children in the Era of the Pneumococcal Conjugate Vaccine

Stoll, Matthew L.; Rubin, Lorry G.

doi:10.1001/archpedi.158.7.671

Cited by 138 publications

(101 citation statements)

References 30 publications

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“…Although we have no concrete explanation for this fi nding, it may refl ect decreasing concern about bacteremia in general because rou tine vaccination against pneumococcus began in 2000 in the United States. 11,18,19 This hypothesis is supported by our demonstration that the decrease was more pronounced in infants aged ≥4 months. The reported prevalence from previous studies of bacteremic UTIs in children is variable.…”

Section: Discussionsupporting

confidence: 65%

Diagnosis and Management of Bacteremic Urinary Tract Infection in Infants

Román

Chang

Schroeder

2015

Hospital Pediatrics

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Objectives: To report the prevalence of bacteremia by age in a sample of infants <1 year of age with urinary tract infections (UTIs), to compare characteristics of infants with UTIs with and without bacteremia, and to describe treatment courses and 30-day outcomes in infants with UTIs with and without bacteremia. Methods: We used a retrospective cross-sectional design to determine the prevalence of bacteremia in infants with UTIs at our institution. A double cohort design matching for age and gender was used to compare clinical characteristics and outcomes between infants with bacteremic versus nonbacteremic UTIs. Results: We identified 1379 UTIs, with blood cultures obtained in 52% of cases. The prevalence of bacteremia was 4.1% (95% confidence interval 3.1%–5.3%) for all UTIs and 8% (95% confidence interval 6.1%–10.2%) for UTIs in which blood culture was obtained. Fifty-five infants with bacteremic UTIs were compared with 110 infants with nonbacteremic UTIs. Except for minor differences in the urinalysis and serum band count, there were no significant differences in clinical presentation between the 2 groups. Bacteremic infants received longer parenteral treatment courses than nonbacteremic infants (mean 6.7 vs 2.4 days, P < .001). Treatment courses in the bacteremic group were variable and predicted by age but not severity of illness. No bacteremic infant had recurrent UTI or bacteremia with the same organism within 30 days of discharge. Conclusions: Treatment was variable but outcomes were excellent in infants with bacteremic UTIs.

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Section: Discussionsupporting

confidence: 65%

Diagnosis and Management of Bacteremic Urinary Tract Infection in Infants

Román

Chang

Schroeder

2015

Hospital Pediatrics

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“…Ante una BO por este microorganismo, existe de 1% a 5,8% de riesgo de meningitis, de 6% a 10% de otras infecciones localizadas, 0,8% de letalidad; entre un 70% y un 87,5% puede autolimitarse sin mediar tratamiento. 3,16,[37][38][39][40][41][42][43][44] Aproximadamente, 0,02% de los pacientes de 3 a 36 meses con FSF > 39 °C tienen BO por Nm. La presencia de petequias o lesiones purpúricas fuera del área de Valsalva constituyen un signo de alerta.…”

Section: Fiebre Sin Foco Evidente De Infección En Niños De 3 a 36 Mesunclassified

Consenso para el uso adecuado de antibióticos en el niño menor de 36 meses con fiebre sin foco de infección evidente. Texto completo

2017

Arch Argent Pediat

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“…Stoll ve Rubin'in çalışmasında, 2-36 ay arasında iyi görünen, yüksek ateşi olan çocuklarda gizli bakteriyemi oranı %0,91 bulunmuş ve ateşi olan ama iyi görünen çocuklarda kan kültürünün rutin alınmaması önerilmiştir [9]. Çalışmamızda süt çocuğu servisinde rutin kan kültürü alımı %20,2'den eğitim sonrasında %16,2'e geriledi ancak bu azalma istatistiksel olarak anlamlı değildi.…”

Section: İstatistiksel Analizunclassified