TY - JOUR
T1 - Prevalence of serious bacterial infections in return visits to the emergency department among infants aged 90 days or younger
AU - Levasseur, Kelly Anne
AU - Stankovic, Curt
AU - Duffy, Elizabeth
AU - Du, Wei
AU - Mahajan, Prashant
N1 - Publisher Copyright:
Copyright © 2014 Lippincott Williams & Wilkins.
PY - 2014/10/12
Y1 - 2014/10/12
N2 - OBJECTIVE: The main objective of this study was to describe the epidemiology of return visits (RVs) in well-appearing infants to an urban emergency department (ED) who were evaluated for serious bacterial infection (SBI) at their index ED visit. METHODS: We conducted a retrospective chart review on infants aged 90 days and younger who were evaluated for SBI at their initial ED visit from 2003 through 2009. A parent database of all febrile infants evaluated for SBI was queried to identify patients who had an RV within 7 days of the index visit. We collected demographic variables including age, sex, and past medical history as well as laboratory test results including white blood cell count, blood, urine, and cerebrospinal fluid cultures and viral studies. RESULTS: Of eligible febrile infants, 10.8% (350/3220) had an RV to the ED within 7 days. The prevalence of SBI in the RV cohort was 6.0% (21/350), which included 1.7% (6/350) bacteremia, 3.7% (13/350) urinary tract infection, and 0.6% (2/350) combined urinary tract infection and bacteremia. The blood culture contamination rate was 88%. CONCLUSIONS: Infants aged 90 days or younger who are evaluated for SBI have high RV rates. A substantial number of RVs are due to contaminated blood cultures. Future studies should be conducted to identify predictors for false-positive blood cultures.
AB - OBJECTIVE: The main objective of this study was to describe the epidemiology of return visits (RVs) in well-appearing infants to an urban emergency department (ED) who were evaluated for serious bacterial infection (SBI) at their index ED visit. METHODS: We conducted a retrospective chart review on infants aged 90 days and younger who were evaluated for SBI at their initial ED visit from 2003 through 2009. A parent database of all febrile infants evaluated for SBI was queried to identify patients who had an RV within 7 days of the index visit. We collected demographic variables including age, sex, and past medical history as well as laboratory test results including white blood cell count, blood, urine, and cerebrospinal fluid cultures and viral studies. RESULTS: Of eligible febrile infants, 10.8% (350/3220) had an RV to the ED within 7 days. The prevalence of SBI in the RV cohort was 6.0% (21/350), which included 1.7% (6/350) bacteremia, 3.7% (13/350) urinary tract infection, and 0.6% (2/350) combined urinary tract infection and bacteremia. The blood culture contamination rate was 88%. CONCLUSIONS: Infants aged 90 days or younger who are evaluated for SBI have high RV rates. A substantial number of RVs are due to contaminated blood cultures. Future studies should be conducted to identify predictors for false-positive blood cultures.
KW - bacteremia
KW - febrile infant
KW - meningitis
KW - return visit
KW - serious bacterial infection
KW - urinary tract infection
UR - http://www.scopus.com/inward/record.url?scp=84930083487&partnerID=8YFLogxK
U2 - 10.1097/PEC.0000000000000230
DO - 10.1097/PEC.0000000000000230
M3 - Article
C2 - 25272076
AN - SCOPUS:84930083487
VL - 30
SP - 694
EP - 698
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
SN - 0749-5161
IS - 10
ER -