A retrospective review of serious infections in febrile infants 0–90 days old
Background: Fever without source in infants is a common clinical problem that accounts for many ambulatory care visits and hospitalisations. Currently, there is no reliable method of identifying those at risk of serious infection (SI). Objective: The goal of this study was to determine the incidence...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-12-01
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| Series: | Proceedings of Singapore Healthcare |
| Online Access: | https://doi.org/10.1177/20101058211026003 |
| _version_ | 1811197747766755328 |
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| author | Zi Xean Khoo Cherie Chua Zhi Min Yap Janine Cynthia Koh Sarah Xin Chong Nishanti Han Ying Wijedasa Kaitian Peng Chia Yin Chong |
| author_facet | Zi Xean Khoo Cherie Chua Zhi Min Yap Janine Cynthia Koh Sarah Xin Chong Nishanti Han Ying Wijedasa Kaitian Peng Chia Yin Chong |
| author_sort | Zi Xean Khoo |
| collection | DOAJ |
| description | Background: Fever without source in infants is a common clinical problem that accounts for many ambulatory care visits and hospitalisations. Currently, there is no reliable method of identifying those at risk of serious infection (SI). Objective: The goal of this study was to determine the incidence and identify the predictors of SI in febrile infants who presented to the emergency department (ED). Methods: This was a single-centre retrospective cohort study of children presenting to a Singapore tertiary hospital paediatric unit between 1 July 2018 and 31 December 2018. Children were included if they were aged 0–90 days and presented to the ED with a fever. SI was defined as urinary tract infection (UTI), sepsis, bacteraemia, meningitis (viral and bacterial), enterocolitis, osteomyelitis, abscess or pneumonia. Results: Of the 659 infants, 161 (24.4%) were diagnosed with SI. Meningitis (49.7%) was the most common SI, followed by UTI (45.3%), enterocolitis (5.6%), sepsis (3.1%) and bacteraemia (2.5%). Factors significantly associated with SI were aged 29–60 days, male sex, Severity Index Score (SIS) <10, absolute neutrophil counts >10×10 9 /L, C-reactive protein (CRP) >20 mg/L and procalcitonin >0.5 ng/mL. Multivariate analysis entering all these items retained only male sex, SIS <10 and CRP >20. Conclusion: Among hospitalised infants aged 0–90 days, the incidence of SI was 24.4%, and invasive bacterial infection was 0.6%. Meningitis was the most common SI followed by UTI. SIS and CRP can be used to predict SI in infants <90 days old. |
| first_indexed | 2024-04-12T01:19:33Z |
| format | Article |
| id | doaj.art-36cd40ef49954680b26e01e59a73268d |
| institution | Directory Open Access Journal |
| issn | 2059-2329 |
| language | English |
| last_indexed | 2024-04-12T01:19:33Z |
| publishDate | 2022-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Proceedings of Singapore Healthcare |
| spelling | doaj.art-36cd40ef49954680b26e01e59a73268d2022-12-22T03:53:50ZengSAGE PublishingProceedings of Singapore Healthcare2059-23292022-12-013110.1177/20101058211026003A retrospective review of serious infections in febrile infants 0–90 days oldZi Xean Khoo0Cherie Chua1Zhi Min Yap2Janine Cynthia Koh3Sarah Xin Chong4Nishanti Han Ying Wijedasa5Kaitian Peng6Chia Yin Chong7Duke-NUS Medical School, SingaporeDepartment of Paediatric Medicine, General Paediatric and Ambulatory Service, KK Women’s and Children’s Hospital, SingaporeDepartment of Paediatric Medicine, General Paediatric and Ambulatory Service, KK Women’s and Children’s Hospital, SingaporeDepartment of Paediatric Medicine, General Paediatric and Ambulatory Service, KK Women’s and Children’s Hospital, SingaporeDepartment of Paediatric Medicine, General Paediatric and Ambulatory Service, KK Women’s and Children’s Hospital, SingaporeDepartment of Paediatric Medicine, General Paediatric and Ambulatory Service, KK Women’s and Children’s Hospital, SingaporeDepartment of Paediatric Medicine, General Paediatric and Ambulatory Service, KK Women’s and Children’s Hospital, SingaporeDuke-NUS Medical School, SingaporeBackground: Fever without source in infants is a common clinical problem that accounts for many ambulatory care visits and hospitalisations. Currently, there is no reliable method of identifying those at risk of serious infection (SI). Objective: The goal of this study was to determine the incidence and identify the predictors of SI in febrile infants who presented to the emergency department (ED). Methods: This was a single-centre retrospective cohort study of children presenting to a Singapore tertiary hospital paediatric unit between 1 July 2018 and 31 December 2018. Children were included if they were aged 0–90 days and presented to the ED with a fever. SI was defined as urinary tract infection (UTI), sepsis, bacteraemia, meningitis (viral and bacterial), enterocolitis, osteomyelitis, abscess or pneumonia. Results: Of the 659 infants, 161 (24.4%) were diagnosed with SI. Meningitis (49.7%) was the most common SI, followed by UTI (45.3%), enterocolitis (5.6%), sepsis (3.1%) and bacteraemia (2.5%). Factors significantly associated with SI were aged 29–60 days, male sex, Severity Index Score (SIS) <10, absolute neutrophil counts >10×10 9 /L, C-reactive protein (CRP) >20 mg/L and procalcitonin >0.5 ng/mL. Multivariate analysis entering all these items retained only male sex, SIS <10 and CRP >20. Conclusion: Among hospitalised infants aged 0–90 days, the incidence of SI was 24.4%, and invasive bacterial infection was 0.6%. Meningitis was the most common SI followed by UTI. SIS and CRP can be used to predict SI in infants <90 days old.https://doi.org/10.1177/20101058211026003 |
| spellingShingle | Zi Xean Khoo Cherie Chua Zhi Min Yap Janine Cynthia Koh Sarah Xin Chong Nishanti Han Ying Wijedasa Kaitian Peng Chia Yin Chong A retrospective review of serious infections in febrile infants 0–90 days old Proceedings of Singapore Healthcare |
| title | A retrospective review of serious infections in febrile infants 0–90 days old |
| title_full | A retrospective review of serious infections in febrile infants 0–90 days old |
| title_fullStr | A retrospective review of serious infections in febrile infants 0–90 days old |
| title_full_unstemmed | A retrospective review of serious infections in febrile infants 0–90 days old |
| title_short | A retrospective review of serious infections in febrile infants 0–90 days old |
| title_sort | retrospective review of serious infections in febrile infants 0 90 days old |
| url | https://doi.org/10.1177/20101058211026003 |
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