Evidence map›Paper›PMID 33239319›Full record

ArticleHospital pediatrics2020

Febrile Infants ≤60 Days Old With Positive Urinalysis Results and Invasive Bacterial Infections.

Lyubina C Yankova, Mark I Neuman, Marie E Wang, Christopher Woll, Adrienne G DePorre, Sanyukta Desai, Laura F Sartori, Lise E Nigrovic, Christopher M Pruitt, Richard D Marble and 4 more

Open access · greenAbstract read
In one paragraph

Article in Hospital pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 11 institutions in 1 country.

Lyubina C YankovaDepartments of Pediatrics and.
Mark I NeumanDivision of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital.
Marie E WangDivision of Pediatric Hospital Medicine, Department of Pediatrics, Lucile Packard Children's Hospital Stanford, School of Medicine, Stanford University, Palo Alto, California.
Christopher WollDepartments of Pediatrics and.
Adrienne G DePorreDivision of Hospital Medicine, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.
Sanyukta DesaiDivision of Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Laura F SartoriDivision of Pediatric Emergency Medicine, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt and School of Medicine, Vanderbilt University, Nashville, Tennessee.
Lise E NigrovicDivision of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital.
Christopher M PruittDivision of Pediatric Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
Richard D MarbleDivision of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago and Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Rianna C LeazerDivision of Hospital Medicine, Department of Pediatrics, Children's Hospital of The King's Daughters, Norfolk, Virginia.
Sahar N RooholaminiDivision of Hospital Medicine, Department of Pediatrics, Seattle Children's Hospital and School of Medicine, University of Washington, Seattle, Washington; and.
Fran BalamuthDivision of Emergency Medicine and Center for Pediatric Clinical Effectiveness, Department of Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Paul L AronsonDepartments of Pediatrics and paul.aronson@yale.edu.
Boston Children's Hospital · USChildren's Hospital of The King's Daughters · USChildren's Mercy Hospital · USLurie Children's Hospital · USStanford University · USUniversity of Alabama at Birmingham · USUniversity of Cincinnati · USUniversity of Pennsylvania · USUniversity of Washington · USVanderbilt University · USYale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Institutional Career Development CoreKL2TR001862 · NCATS · YALE UNIVERSITY · PI CANTLEY, LLOYD G, EDELMAN, E. JENNIFER · 2016 to 2025
$12.2M
Development and pilot trial of a web-based tool to facilitate shared decision-making with parents of febrile infantsK08HS026006 · AHRQ · YALE UNIVERSITY · PI ARONSON, PAUL L · 2018 to 2020
$460k
AHRQ HHS K08 HS026006NCATS NIH HHS KL2 TR001862NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

objectivesWe aimed to describe the clinical and laboratory characteristics of febrile infants ≤60 days old with positive urinalysis results and invasive bacterial infections (IBI).

methodsWe performed a planned secondary analysis of a retrospective cohort study of febrile infants ≤60 days old with IBI who presented to 11 emergency departments from July 1, 2011, to June 30, 2016. For this subanalysis, we included infants with IBI and positive urinalysis results. We analyzed the sensitivity of high-risk past medical history (PMH) (prematurity, chronic medical condition, or recent antimicrobial receipt), ill appearance, and/or abnormal white blood cell (WBC) count (<5000 or >15 000 cells/μL) for identification of IBI.

resultsOf 148 febrile infants with positive urinalysis results and IBI, 134 (90.5%) had bacteremia without meningitis and 14 (9.5%) had bacterial meningitis (11 with concomitant bacteremia). Thirty-five infants (23.6%) with positive urinalysis results and IBI did not have urinary tract infections. The presence of high-risk PMH, ill appearance, and/or abnormal WBC count had a sensitivity of 53.4% (95% confidence interval: 45.0-61.6) for identification of IBI. Of the 14 infants with positive urinalysis results and concomitant bacterial meningitis, 7 were 29 to 60 days old. Six of these 7 infants were ill-appearing or had an abnormal WBC count. The other infant had bacteremia with cerebrospinal fluid pleocytosis after antimicrobial pretreatment and was treated for meningitis.

conclusionsThe sensitivity of high-risk PMH, ill appearance, and/or abnormal WBC count is suboptimal for identifying febrile infants with positive urinalysis results at low risk for IBI. Most infants with positive urinalysis results and bacterial meningitis are ≤28 days old, ill-appearing, or have an abnormal WBC count.

Indexed as

BacteremiaBacterial InfectionsMeningitis, BacterialUrinary Tract InfectionsFeverHumansInfantRetrospective StudiesUrinalysis

Identifiers

PMID33239319
PMCPMC7684554
OpenAlexW3107325180

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.