Archives of disease in childhood · 2025
Prevalence of invasive bacterial infection among febrile infants with positive urinalysis results: a planned secondary analysis of the Febrile Infants Diagnostic assessment and Outcome (FIDO) prospective observational cohort study.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Drummond Holly, Umana Etimbuk, Mills Clare, Waterfield Thomas
Аннотация
OBJECTIVE: To determine the prevalence of invasive bacterial infection (IBI) in a UK cohort of febrile infants aged 90 days and younger with positive urinalysis (PU) results.
DESIGN: A planned secondary analysis of data from the Febrile Infant Diagnostic Assessment and Outcome study, a prospective multicentre observational cohort study.
SETTING: 35 paediatric emergency departments and assessment units across the UK and Ireland, between 6 July 2022 and 31 August 2023.
PATIENTS: Febrile infants aged 90 days and younger presenting to emergency care.
MAIN OUTCOME MEASURES: IBI rates, namely bacterial meningitis or bacteraemia, among febrile infants with PU results were compared with those with negative urinalysis (NU) results.
RESULTS: 1480 of 1821 infants underwent urinalysis testing. 549 infants had PU results and 931 had NU results. 42/549 (7.7%) and 20/931 (2.2%) infants had IBI in the PU and NU groups, respectively. Of the IBI cases within the PU group, 5/549 (0.9%) were bacterial meningitis and 39/549 (7.1%) were bacteraemia, with two concomitant cases. Of the IBI cases in the NU group, there were 4/931 (0.4%) cases of bacterial meningitis and 18/931 (1.9%) cases of bacteraemia, with two concomitant cases. There were no bacterial meningitis cases in infants over 60 days of age or those with confirmed urinary tract infection (UTI).
CONCLUSIONS: The prevalence of bacteraemia was high (7.1%) among PU infants, while the prevalence of bacterial meningitis was low (0.9%), with PU or NU. These findings support existing data that older infants with suspected UTI are at low risk of bacterial meningitis.
DESIGN: A planned secondary analysis of data from the Febrile Infant Diagnostic Assessment and Outcome study, a prospective multicentre observational cohort study.
SETTING: 35 paediatric emergency departments and assessment units across the UK and Ireland, between 6 July 2022 and 31 August 2023.
PATIENTS: Febrile infants aged 90 days and younger presenting to emergency care.
MAIN OUTCOME MEASURES: IBI rates, namely bacterial meningitis or bacteraemia, among febrile infants with PU results were compared with those with negative urinalysis (NU) results.
RESULTS: 1480 of 1821 infants underwent urinalysis testing. 549 infants had PU results and 931 had NU results. 42/549 (7.7%) and 20/931 (2.2%) infants had IBI in the PU and NU groups, respectively. Of the IBI cases within the PU group, 5/549 (0.9%) were bacterial meningitis and 39/549 (7.1%) were bacteraemia, with two concomitant cases. Of the IBI cases in the NU group, there were 4/931 (0.4%) cases of bacterial meningitis and 18/931 (1.9%) cases of bacteraemia, with two concomitant cases. There were no bacterial meningitis cases in infants over 60 days of age or those with confirmed urinary tract infection (UTI).
CONCLUSIONS: The prevalence of bacteraemia was high (7.1%) among PU infants, while the prevalence of bacterial meningitis was low (0.9%), with PU or NU. These findings support existing data that older infants with suspected UTI are at low risk of bacterial meningitis.