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Changing Epidemiology of Serious Bacterial Infections in Febrile Infants without Localizing Signs
OBJECTIVE: Historically, management of infants with fever without localizing signs (FWLS) has generated much controversy, with attempts to risk stratify based on several criteria. Advances in medical practice may have altered the epidemiology of serious bacterial infections (SBIs) in this population...
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Formato: | Texto |
Lenguaje: | English |
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Public Library of Science
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929196/ https://www.ncbi.nlm.nih.gov/pubmed/20805983 http://dx.doi.org/10.1371/journal.pone.0012448 |
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author | Watt, Kevin Waddle, Erica Jhaveri, Ravi |
author_facet | Watt, Kevin Waddle, Erica Jhaveri, Ravi |
author_sort | Watt, Kevin |
collection | PubMed |
description | OBJECTIVE: Historically, management of infants with fever without localizing signs (FWLS) has generated much controversy, with attempts to risk stratify based on several criteria. Advances in medical practice may have altered the epidemiology of serious bacterial infections (SBIs) in this population. We conducted this study to test the hypothesis that the rate of SBIs in this patient population has changed over time. PATIENTS AND METHODS: We performed a retrospective review of all infants meeting FWLS criteria at our institution from 1997–2006. We examined all clinical and outcome data and performed statistical analysis of SBI rates and ampicillin resistance rates. RESULTS: 668 infants met criteria for FWLS. The overall rate of SBIs was 10.8%, with a significant increase from 2002–2006 (52/361, 14.4%) compared to 1997–2001 (20/307, 6.5%) (p = 0.001). This increase was driven by an increase in E. coli urinary tract infections (UTI), particularly in older infants (31–90 days). CONCLUSIONS: We observed a significant increase in E. coli UTI among FWLS infants with high rates of ampicillin resistance. The reasons are likely to be multifactorial, but the results themselves emphasize the need to examine urine in all febrile infants <90days and consider local resistance patterns when choosing empiric antibiotics. |
format | Text |
id | pubmed-2929196 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-29291962010-08-30 Changing Epidemiology of Serious Bacterial Infections in Febrile Infants without Localizing Signs Watt, Kevin Waddle, Erica Jhaveri, Ravi PLoS One Research Article OBJECTIVE: Historically, management of infants with fever without localizing signs (FWLS) has generated much controversy, with attempts to risk stratify based on several criteria. Advances in medical practice may have altered the epidemiology of serious bacterial infections (SBIs) in this population. We conducted this study to test the hypothesis that the rate of SBIs in this patient population has changed over time. PATIENTS AND METHODS: We performed a retrospective review of all infants meeting FWLS criteria at our institution from 1997–2006. We examined all clinical and outcome data and performed statistical analysis of SBI rates and ampicillin resistance rates. RESULTS: 668 infants met criteria for FWLS. The overall rate of SBIs was 10.8%, with a significant increase from 2002–2006 (52/361, 14.4%) compared to 1997–2001 (20/307, 6.5%) (p = 0.001). This increase was driven by an increase in E. coli urinary tract infections (UTI), particularly in older infants (31–90 days). CONCLUSIONS: We observed a significant increase in E. coli UTI among FWLS infants with high rates of ampicillin resistance. The reasons are likely to be multifactorial, but the results themselves emphasize the need to examine urine in all febrile infants <90days and consider local resistance patterns when choosing empiric antibiotics. Public Library of Science 2010-08-27 /pmc/articles/PMC2929196/ /pubmed/20805983 http://dx.doi.org/10.1371/journal.pone.0012448 Text en Watt et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Watt, Kevin Waddle, Erica Jhaveri, Ravi Changing Epidemiology of Serious Bacterial Infections in Febrile Infants without Localizing Signs |
title | Changing Epidemiology of Serious Bacterial Infections in Febrile Infants without Localizing Signs |
title_full | Changing Epidemiology of Serious Bacterial Infections in Febrile Infants without Localizing Signs |
title_fullStr | Changing Epidemiology of Serious Bacterial Infections in Febrile Infants without Localizing Signs |
title_full_unstemmed | Changing Epidemiology of Serious Bacterial Infections in Febrile Infants without Localizing Signs |
title_short | Changing Epidemiology of Serious Bacterial Infections in Febrile Infants without Localizing Signs |
title_sort | changing epidemiology of serious bacterial infections in febrile infants without localizing signs |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929196/ https://www.ncbi.nlm.nih.gov/pubmed/20805983 http://dx.doi.org/10.1371/journal.pone.0012448 |
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