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• W2318101765 abstract "Research Article| June 01 2012 Etiology of Fever in Young Infants: A Reassessment AAP Grand Rounds (2012) 27 (6): 63. https://doi.org/10.1542/gr.27-6-63 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Etiology of Fever in Young Infants: A Reassessment. AAP Grand Rounds June 2012; 27 (6): 63. https://doi.org/10.1542/gr.27-6-63 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: bacteremia, fever, blood culture, escherichia coli Source: Greenhow TL, Hung Y-Y, Herz AM. Changing epidemiology of bacteremia in infants aged 1 week to 3 months. Pediatrics. 2012; 129(3): e590– e596; doi: https://doi.org/10.1542/peds.2011-1546Google Scholar Investigators from Kaiser Permanente Northern California characterized the etiology of bacteremia in infants aged 1 week to 3 months by retrospectively reviewing the results of blood cultures (BC) obtained from a cohort of 160,818 full-term, previously healthy infants during a 5-year period (2005–2009). Cultures drawn from outpatients, in the emergency department, and within the first 24 hours of admission to the hospital were included. Excluded were infants with underlying medical problems and those born at <37 weeks estimated gestational age. Efforts were made to identify repeatedly positive cultures, which were counted as a single episode of bacteremia. Isolates such as coagulase-negative staphylococci, Micrococcus, and diphtheroids were defined as contaminants (3 children with viridans streptococci and 1 of enterococcal bacteremia were managed as infections). During the 5-year period 340 of 4,255 (8%) BCs were positive. Of these, 93 (2%) were clinically significant and 247 (6%) were considered contaminated. The incidence of true bacteremia was 0.57 per 1,000 live births in this cohort. Escherichia coli was the most common pathogen (56% of cases of bacteremia), followed by group B Streptococcus (GBS) (21%), Staphylococcus aureus (8%), and Streptococcus pneumoniae (3%). There were 3 cases of viridans streptococcal bacteremia, 2 cases each of Klebsiella and Salmonella bacteremia, and single cases of bacteremia due to Citrobacter, Enterococcus faecalis, Moraxella, and Streptococcus pyogenes. Of the 19 episodes of GBS bacteremia, 12 occurred between days 7 and 28, 6 in the second month of life, and 1 in the third month of life. For all other pathogens, there was no age-related pattern. A significantly higher proportion of contaminated BCs were drawn in the emergency department, compared to the outpatient or inpatient setting. Of the 48 infants with E coli bacteremia who had a urine culture (UC) performed, 47 (98%) had a concomitant urinary tract infection (UTI). Of the 38 such infants for whom a cerebrospinal fluid (CSF) culture was performed, 4 (11%) had concomitant meningitis. Of 17 infants with GBS bacteremia who had CSF culture performed, 5 (29%) had concomitant meningitis. There was 1 case of pneumococcal meningitis. Compared to nonbacteremic controls, bacteremic infants had a significantly higher average white blood cell count (13,820/μL vs 10,770/μL). Three of 52 (6%) of the E coli isolates were resistant to ampicillin and gentamicin. The authors conclude that empiric ampicillin treatment in the first 3 months of life may no longer be required, given the absence of Listeria infection and the observed antibiotic resistance in their cohort. Dr Tolan has disclosed no financial relationship relevant to this commentary. Dr. Tolan is on the Speaker’s Bureau for Novartis. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. This is the first study to address the incidence of bacteremia in infants 1 to 3... You do not currently have access to this content." @default.
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• W2318101765 title "Etiology of Fever in Young Infants: A Reassessment" @default.
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