A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan
Background: Serious bacterial infections (SBIs) could lead to mortality or severe long-term sequelae in neonates and infants aged <3 months. Accordingly, the aim of this study was to develop a quantitative and accurate assessment tool for predicting the risk of SBIs in febrile neonates. Methods:...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-11-01
|
| Series: | Pediatrics and Neonatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957222001504 |
| _version_ | 1797984117499887616 |
|---|---|
| author | Shin-Ying Li Chun-Hao Yin Jin-Shuen Chen Yao-Shen Chen Chih-Chieh Yang Nai-Wen Fang Hsiao-Ping Wang Yee-Hsuan Chiou |
| author_facet | Shin-Ying Li Chun-Hao Yin Jin-Shuen Chen Yao-Shen Chen Chih-Chieh Yang Nai-Wen Fang Hsiao-Ping Wang Yee-Hsuan Chiou |
| author_sort | Shin-Ying Li |
| collection | DOAJ |
| description | Background: Serious bacterial infections (SBIs) could lead to mortality or severe long-term sequelae in neonates and infants aged <3 months. Accordingly, the aim of this study was to develop a quantitative and accurate assessment tool for predicting the risk of SBIs in febrile neonates. Methods: This retrospective study enrolled 131 febrile term neonates (aged <30 days) who were hospitalized at Kaohsiung Veterans General Hospital between January 2005 and December 2020. These neonates were classified into SBI and nonbacterial infection (NBI) groups on the basis of microbiological laboratory reports. The clinical characteristics and routine blood tests of both groups at the time of admission were analyzed. Stepwise logistic regression was applied to create and validate the nomogram for SBI prediction. Results: Among the 131 febrile neonates, 38 and 93 developed SBIs and NBIs, respectively. At the time of admission, ill clinical appearance, serum myelocyte/metamyelocyte presence, C-reactive protein (CRP) > 2.5 mg/dL, and pyuria were associated with an increased risk of SBIs. Accordingly, these four factors were used to develop a nomogram for SBI prediction, which exhibited significantly high performance (area under curve = 0.848, p < 0.001) in predicting SBI risk. Conclusion: We developed a nomogram combining clinical appearance, serum myelocyte/metamyelocyte presence, CRP, and pyuria for predicting SBI risk in febrile neonates. This tool can assist clinicians in making early diagnoses and delivering the appropriate treatment. |
| first_indexed | 2024-04-11T06:57:34Z |
| format | Article |
| id | doaj.art-377cc99be1664904b3c3d12ac8182e96 |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-04-11T06:57:34Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-377cc99be1664904b3c3d12ac8182e962022-12-22T04:38:57ZengElsevierPediatrics and Neonatology1875-95722022-11-01636605612A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern TaiwanShin-Ying Li0Chun-Hao Yin1Jin-Shuen Chen2Yao-Shen Chen3Chih-Chieh Yang4Nai-Wen Fang5Hsiao-Ping Wang6Yee-Hsuan Chiou7Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Medical Education and Research, Kaohsiung Veterans General Hospital, Taiwan; Institute of Health Care Management, National Sun Yat-sen University, TaiwanDepartment of Administration, Kaohsiung Veterans General Hospital, TaiwanDepartment of Administration, Kaohsiung Veterans General Hospital, TaiwanDivision of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDivision of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan; Corresponding author. No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813, Taiwan.Background: Serious bacterial infections (SBIs) could lead to mortality or severe long-term sequelae in neonates and infants aged <3 months. Accordingly, the aim of this study was to develop a quantitative and accurate assessment tool for predicting the risk of SBIs in febrile neonates. Methods: This retrospective study enrolled 131 febrile term neonates (aged <30 days) who were hospitalized at Kaohsiung Veterans General Hospital between January 2005 and December 2020. These neonates were classified into SBI and nonbacterial infection (NBI) groups on the basis of microbiological laboratory reports. The clinical characteristics and routine blood tests of both groups at the time of admission were analyzed. Stepwise logistic regression was applied to create and validate the nomogram for SBI prediction. Results: Among the 131 febrile neonates, 38 and 93 developed SBIs and NBIs, respectively. At the time of admission, ill clinical appearance, serum myelocyte/metamyelocyte presence, C-reactive protein (CRP) > 2.5 mg/dL, and pyuria were associated with an increased risk of SBIs. Accordingly, these four factors were used to develop a nomogram for SBI prediction, which exhibited significantly high performance (area under curve = 0.848, p < 0.001) in predicting SBI risk. Conclusion: We developed a nomogram combining clinical appearance, serum myelocyte/metamyelocyte presence, CRP, and pyuria for predicting SBI risk in febrile neonates. This tool can assist clinicians in making early diagnoses and delivering the appropriate treatment.http://www.sciencedirect.com/science/article/pii/S1875957222001504febrile neonatesnomogramserious bacterial infection |
| spellingShingle | Shin-Ying Li Chun-Hao Yin Jin-Shuen Chen Yao-Shen Chen Chih-Chieh Yang Nai-Wen Fang Hsiao-Ping Wang Yee-Hsuan Chiou A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan Pediatrics and Neonatology febrile neonates nomogram serious bacterial infection |
| title | A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan |
| title_full | A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan |
| title_fullStr | A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan |
| title_full_unstemmed | A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan |
| title_short | A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan |
| title_sort | nomogram for predicting the development of serious bacterial infections in febrile term neonates a single medical center experience in southern taiwan |
| topic | febrile neonates nomogram serious bacterial infection |
| url | http://www.sciencedirect.com/science/article/pii/S1875957222001504 |
| work_keys_str_mv | AT shinyingli anomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT chunhaoyin anomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT jinshuenchen anomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT yaoshenchen anomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT chihchiehyang anomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT naiwenfang anomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT hsiaopingwang anomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT yeehsuanchiou anomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT shinyingli nomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT chunhaoyin nomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT jinshuenchen nomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT yaoshenchen nomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT chihchiehyang nomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT naiwenfang nomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT hsiaopingwang nomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan AT yeehsuanchiou nomogramforpredictingthedevelopmentofseriousbacterialinfectionsinfebriletermneonatesasinglemedicalcenterexperienceinsoutherntaiwan |