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Factors predicting serious bacterial infections in febrile infants less than three months old: multivariate analysis

, : Factors predicting serious bacterial infections in febrile infants less than three months old: multivariate analysis. Archives de Pediatrie 12(4): 397-403

To identify predictive factors of the presence of a serious bacterial infection (SBI) in febrile infants less than three months old. Retrospective analysis of the medical files of 315 consecutive consultations of febrile infants less than three months old in the pediatric emergency department of a French hospital, with logistic regression multivariate analysis of the different criteria routinely considered and C-reactive protein (CRP). SBI were diagnosed in 79 (25.1%) infants, primarily urinary tract infections (71; 22.5%). One of these 79 children had pneumococcal meningitis but met the classical criteria for low risk of SBI: he died because antibiotics were not prescribed sufficiently early. Factors significantly associated with SBI were: male sex; temperature >38.5 degrees C and lasting >24 hours; poor general condition; absence of ear, nose and throat symptoms; high white blood cell count with >50% neutrophils; and serum CRP concentration >20 mg/l. Multivariate analysis entering all these items retained only the latter two (respectively, OR: 13.5, 95% CI: [6.5-28.2] and OR: 2.9; 95% CI: [1.3-6.3]). CRP <20 mg/l and <50% neutrophils had a negative-predictive value of 93.1% for the absence of SBI. At present, no factor(s) is(are) able to predict with 100% accuracy the absence of SBI in febrile infants less than three months old. The risk of severe sequelae or death caused by untreated SBI would seem to justify the prescription of antibiotics until microbacterial culture results become available.


PMID: 15808428

DOI: 10.1016/j.arcped.2005.01.005

Other references

Will, E.J.; Bartlett, C.; Thomas, K.; Ansell, D., 2003: Blood pressure control in ESRD The achieved, the achievable and the aspirational Data from the UK Renal Registry. Journal of the American Society of Nephrology 14(Abstracts Issue): 261A, November

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Bodenheimer, F.S., 1944: Note on the Coccoidea of Iran, with Descriptions of new Species (Hemiptera-Homoptera). Records based on the literature, which is reviewed, and on the author's own observations in 1943 are given of the distribution and food-plants of 62 species of Coccids from Persia, including four new ones, which are described, and the zoogeog...

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Ueda H.; Murao S.; Sakamoto T.; Uozumi Z.; Chang S.Y.; Nakamura H., 1970: Physiologic reappraisal of so called apical mitral murmurs with particular reference to the pattern of transmission. Japanese Circulation Journal 34(9): 824

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Kidd, S.A., 1995: Congenital heart disease: a 10 year cohort. Journal of Paediatrics and Child Health 31(4): 362-362

Frosio, G.; Dändliker, R., 1994: Reciprocal reflection interferometer for a fiber-optic Faraday current sensor. A reciprocal fiber-optic reflection interferometer for remote measurement of electrical current through the Faraday effect is described. The effects of polarization cross coupling because of nonideal elements are eliminated with a low-coherence so...