Document Detail

Blood culture and bacteremia predictors in infants less than three months of age with fever without source.
MedLine Citation:
PMID:  19934784     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: (1) To assess the rate of bacteremia in febrile infants less than 3 months of age admitted to a pediatric emergency department at a tertiary hospital; (2) to describe the bacteria isolated; and (3) to analyze factors related to increased probability of having a positive blood culture. METHODS: A retrospective, cross-sectional, 5-year descriptive study that includes all infants less than 3 months of age who presented with fever without source (FWS) and had a blood culture performed. RESULTS: A blood culture was performed in 1018 (91.5%) of 1125 infants admitted, and a bacterial pathogen was grown in 23 (2.2%) of these; 8 were associated with a positive urine culture. The most frequently isolated pathogen was Escherichia coli (9), followed by Streptococcus pneumoniae (4). The risk factors detected by multivariate analysis were: (a) being classified as "not well-appearing" (12.5% vs. 1.8%; odds ratio: 8.37) and (b) leukocyturia and/or nitrituria in a urine dipstick test (5.6% vs. 1.6%; odds ratio: 3.73). C-reactive protein value was higher than white blood cell count and absolute neutrophil count in detecting bacteremia; a 70 g/L cut-off had a specificity of 93.8%, but sensitivity of only 69.6%. CONCLUSIONS: A positive blood culture rate of 2.2% was found in infants less than 3 months of age with FWS. C-reactive protein, white blood cell count, and absolute neutrophil count were not good bacteremia predictors. We recommend obtaining a blood culture in infants less than 3 months of age with FWS, particularly those patients considered "not well-appearing" and those with leukocyturia and/or nitrituria.
Borja G?mez; Santiago Mintegi; Javier Benito; Andere Egireun; Diego Garcia; Eider Astobiza
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  29     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-29     Completed Date:  2010-02-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-7     Citation Subset:  IM    
From the Paediatric Emergency Department, Cruces Hospital, Plaza de Cruces s/n, Barakaldo, Spain.
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MeSH Terms
Bacteremia / epidemiology*,  microbiology
Bacteria / classification*,  isolation & purification*
Blood / microbiology*
C-Reactive Protein / analysis
Cross-Sectional Studies
Emergency Service, Hospital
Escherichia coli / isolation & purification
Fever of Unknown Origin / etiology*
Infant, Newborn
Leukocyte Count
Retrospective Studies
Streptococcus pneumoniae / isolation & purification
Reg. No./Substance:
9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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