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Journal of Pediatrics, The

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Prevalence of Invasive Bacterial Infection in Hypothermic Young Infants: A Multisite Study - 05/07/23

Doi : 10.1016/j.jpeds.2023.113407 
Jennifer L. Raffaele, MD 1, ⁎ , Meenu Sharma, DO 2, Stephanie Berger, MD 2, Meredith Mitchell, MD 3, Clifton Lee, MD 3, John Morrison, MD, PhD 4, 5, Madhuri Prasad, MD 4, Monica D. Combs, MD 6, Kira Molas-Torreblanca, DO 6, Julie K. Wood, DO 7, Annalise Van Meurs, MD 8, Kathryn Westphal, MD 9, 10, Ali Sawani, DO 10, Sumeet L. Banker, MD, MPH 11, Jennifer Lee, MD 11, Coleton King, MS 12, Elizabeth E. Halvorson, MS, MD 7, Nicholas M. Potisek, MD 1, 7
on behalf of the

Hypothermic Young Infant Research Collaborative

Saylor McCartor, DO 13, Vignesh Doraiswamy, MD 14, 15, Sanford Williams, MD 16
13 Department of Pediatrics, University of South Carolina School of Medicine Greenville, Prisma Health Children's Hospital-Upstate, Greenville, NC 
14 Division of Hospital Medicine, Nationwide Children's Hospital, Columbus, OH 
15 Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 
16 Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY 

1 Department of Pediatrics, University of South Carolina School of Medicine Greenville, Prisma Health Children's Hospital-Upstate, Greenville, NC 
2 Department of Pediatrics, University of Alabama Heersink School of Medicine, Birmingham, AL 
3 Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 
4 Division of Pediatric Hospital Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, FL 
5 Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 
6 Department of Pediatrics, Keck School of Medicine of USC, Children's Hospital Los Angeles, Los Angeles, CA 
7 Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 
8 Department of Pediatrics, Oregon Health and Science University, Doernbecher Children's Hospital, Portland, OR 
9 Division of Hospital Medicine, Nationwide Children's Hospital, Columbus, OH 
10 Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 
11 Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY 
12 Department of Psychology, Clemson University, Clemson, SC 

∗Reprint requests: Jennifer L. Raffaele, MD, Assistant Professor Prisma Health Children's Hospital Upstate Division of Pediatric Hospital Medicine, Department of Pediatrics, 701 Grove Rd, Greenville SC, 29605.Assistant Professor Prisma Health Children's Hospital Upstate Division of Pediatric Hospital MedicineDepartment of Pediatrics701 Grove RdGreenvilleSC29605

Abstract

Objective

To determine the prevalence of bacteremia and meningitis (invasive bacterial infection [IBI]) in hypothermic young infants, and also to determine the prevalence of serious bacterial infections (SBI) and neonatal herpes simplex virus and to identify characteristics associated with IBI.

Study design

We conducted a retrospective cohort study of infants ≤90 days of age who presented to 1 of 9 hospitals with historical or documented hypothermia (temperature ≤36.0°C) from September 1, 2017, to May 5, 2021. Infants were identified by billing codes or electronic medical record search of hypothermic temperatures. All charts were manually reviewed. Infants with hypothermia during birth hospitalization, and febrile infants were excluded. IBI was defined as positive blood culture and/or cerebrospinal fluid culture treated as a pathogenic organism, whereas SBI also included urinary tract infection. We used multivariable mixed-effects logistic regression to identify associations between exposure variables and IBI.

Results

Overall, 1098 young infants met the inclusion criteria. IBI prevalence was 2.1% (95% CI, 1.3-2.9) (bacteremia 1.8%; bacterial meningitis 0.5%). SBI prevalence was 4.4% (95% CI, 3.2-5.6), and neonatal herpes simplex virus prevalence was 1.3% (95% CI, 0.6-1.9). Significant associations were found between IBI and repeated temperature instability (OR, 4.9; 95% CI, 1.3-18.1), white blood cell count abnormalities (OR, 4.8; 95% CI, 1.8-13.1), and thrombocytopenia (OR, 5.0; 95% CI, 1.4-17.0).

Conclusions

IBI prevalence in hypothermic young infants is 2.1%. Further understanding of characteristics associated with IBI can guide the development decision tools for management of hypothermic young infants.

Le texte complet de cet article est disponible en PDF.

Abbreviations : CRP, CNS, HSV, CSF, IBI, ICD, ED, EMR, PCR, SBI, WBC, UTI


Plan


 Conflict of Interest Disclosures: The authors have no conflicts of interest relevant to this article to disclose.
 Funding/Support: none.


© 2023  Elsevier Inc. Tous droits réservés.
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Vol 258

Article 113407- juillet 2023 Retour au numéro
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