Summary

Fever in infants under three months old: incidence of potentially serious bacterial infection and the usefulness of rapid diagnostic tests

Gargallo Burriel E, Ricart Campos S, García García JJ, Garrido Romero R, Muñoz Almagro C, Gené Giralt A, Luaces Cubells C

Affiliation of the authors

PAEDIATRIC EMERGENCY DEPARTMENT, DEPARTMENT OF PAEDIATRICS. DEPARTMENT OF MICROBIOLOGY, SANT JOAN DE DEU-HOSPITAL CLÍNIC INTEGRATED UNIT, UNIVERSITY OF BARCELONA.

DOI

Quote

Gargallo Burriel E, Ricart Campos S, García García JJ, Garrido Romero R, Muñoz Almagro C, Gené Giralt A, et al. Fever in infants under three months old: incidence of potentially serious bacterial infection and the usefulness of rapid diagnostic tests. Emergencias. 2007;19:173-9

Summary

Aims:To assess the incidence and aetiology of potentially serious

bacterial disease (PSBD), viral infection and viral-bacterial coinfection

in a sample of febrile infants aged less than three

months.

Methods: Prospective study of infants aged less than three months admitted

to our hospital because of fever. A complete sepsis study was

performed in all cases, with lumbar tap in selected cases. PSBD is defined

as the growth of bacteria in blood, urine or cebrospinal fluid

(CSF). The presence of Respiratory Syncitial Virus and of influenza A

and B viruses was assessed during the epidemic period, and enteroviruses

were investigated using the polymerase chain reaction in eleven

patients aged less than one month. The SPSS 12.0 software was used

for the analysis.

Results: The study population comprised 136 infants aged less than three

months. Seventy patients (51.5%) met the Rochester low-risk criteria.

The most common final diagnoses were non-focal febrile syndrome

and urinary infection. PSBD was demonstrated in 33 cases (24.3%)

(31 urine cultures, 2 CSF cultures and 7 blood cultures were positive).

The incidence of documented viral infection was 30.8%. Viral and bacterial

coinfection was demonstrated in 2 cases (4.8% of the total number

of virus-infected patients). Enterovirus was demonstrated in the

CSF in 5 (45.5%) of 11 cases studied; none of them had positive bacterial

cultures.

Discussion: In the present study, urinary infection was the most frequently

occurring potentially serious bacterial disease, with an incidence

higher than those reported in other series. The inclusion of rapid virological

diagnostic tests in the diagnostic algorithms helps in selecting

those infants with lower risk of bacterial infection and opens new perspectives

for the management of febrile infants aged less than three

months.

 

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