ArticlePediatric emergency care2019
Application of the Rochester Criteria to Identify Febrile Infants With Bacteremia and Meningitis.
Article in Pediatric emergency care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Prevalence of Bacterial Meningitis Among Febrile Infants Aged 29-60 Days With Positive Urinalysis Results: A Systematic Review and Meta-analysis.JAMA network open · 2021Pooled it
- Impact of implementing a clinical decision rule on the use of empirical antibiotics and invasive procedures.BMJ paediatrics open · 2026Article
- Application of the PECARN prediction rule for febrile infants up to 90 days of age: a multi-center study.BMC pediatrics · 2025Article
- Occult Serious Bacterial Infections in Neonates and Infants Up to Three Months of Age with Bronchiolitis: Are Invasive Cultures Required?Antibiotics (Basel, Switzerland) · 2024Article
- Management of well-appearing febrile young infants aged ≤90 days.Paediatrics & child health · 2024Review
- La prise en charge des nourrissons de 90 jours ou moins, fiévreux mais dans un bon état général.Paediatrics & child health · 2024Review
- The Impact of Respiratory Symptoms on the Risk of Serious Bacterial Infection in Febrile Infants < 60 Days Old.Journal of clinical medicine · 2023Article
- Prevalence of Invasive Bacterial Infections in Well-Appearing, Febrile Infants.Hospital pediatrics · 2021Article
- Cost Analysis of Emergency Department Criteria for Evaluation of Febrile Infants Ages 29 to 90 Days.The Journal of pediatrics · 2021Article
- Characteristics of Afebrile Infants ≤60 Days of Age With Invasive Bacterial Infections.Hospital pediatrics · 2021Article
- Comparing febrile children presenting on and off antibiotics to the emergency department: a retrospective cohort study.BMC pediatrics · 2020Article
- Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture.Pediatrics · 2018Article
- Impact of a Hypothermic Young Infant Clinical Pathway: A Single Site Study.Sage open pediatricsArticle
Corrections and comments
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Authors and funding
11 authors at 7 institutions in 1 country.
Funding
Abstract
objectivesThe Rochester criteria were developed to identify febrile infants aged 60 days or younger at low-risk of bacterial infection and do not include cerebrospinal fluid (CSF) testing. Prior studies have not specifically assessed criteria performance for bacteremia and bacterial meningitis (invasive bacterial infection). Our objective was to determine the sensitivity of the Rochester criteria for detection of invasive bacterial infection.
methodsRetrospective cohort study of febrile infants aged 60 days or younger with invasive bacterial infections evaluated at 8 pediatric emergency departments from July 1, 2012, to June 30, 2014. Potential cases were identified from the Pediatric Health Information System using International Classification of Diseases, Ninth Revision diagnosis codes for bacteremia, meningitis, urinary tract infection, and fever. Medical record review was then performed to confirm presence of an invasive bacterial infection and to evaluate the Rochester criteria: medical history, symptoms or ill appearance, results of urinalysis, complete blood count, CSF testing (if obtained), and blood, urine, and CSF culture. An invasive bacterial infection was defined as growth of pathogenic bacteria from blood or CSF culture.
resultsAmong 82 febrile infants aged 60 days or younger with invasive bacterial infection, the sensitivity of the Rochester criteria were 92.7% (95% confidence interval [CI], 84.9%-96.6%) overall, 91.7% (95% CI, 80.5%-96.7%) for neonates 28 days or younger, and 94.1% (95% CI, 80.9%-98.4%) for infants aged 29 to 60 days old. Six infants with bacteremia, including 1 neonate with bacterial meningitis, met low-risk criteria.
conclusionsThe Rochester criteria identified 92% of infants aged 60 days or younger with invasive bacterial infection. However, 1 neonate 28 days or younger with meningitis was classified as low-risk.
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