Observational studyPediatrics2022
Serious Bacterial Infections in Young Febrile Infants With Positive Urinalysis Results.
Observational study in Pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 16 citations in OpenAlex.
- 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.Archives of disease in childhood · 2025Observational
- Correlation between single nucleotide polymorphisms in TLR4, LTA and RFP175 genes and susceptibility to invasive bacterial infections in infants under three months of age: A case control study.Pakistan journal of medical sciences · 2025Article
- Clinical and Laboratory Characteristics of Neonates Treated Due to Suspected Serious Bacterial Infection: Single Center Cross-Sectional Study.Pediatric reports · 2025Article
- Review
- Inflammatory Markers and Invasive Bacterial Infection in Febrile Infants With Positive Urinalyses.Pediatrics · 2025Article
- Scoping review of clinical decision aids in the assessment and management of febrile infants under 90 days of age.BMC pediatrics · 2025Article
- Fever without source in infants aged 22-60 days: how laboratory tests perform at identifying bacterial infections and predicting the need for a lumbar puncture?World journal of emergency medicine · 2025Article
- La prise en charge des nourrissons de 90 jours ou moins, fiévreux mais dans un bon état général.Paediatrics & child health · 2024Review
- Management of well-appearing febrile young infants aged ≤90 days.Paediatrics & child health · 2024Review
- Conundrums in the Management of Febrile Infants under Three Months of Age and Future Research.Antibiotics (Basel, Switzerland) · 2024Review
- Clinical characteristics and outcomes in febrile infants aged 29-90 days with urinary tract infections and cerebrospinal fluid pleocytosis.Frontiers in pediatrics · 2023Article
Corrections and comments
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Authors and funding
47 authors at 20 institutions in 1 country.
Funding
Abstract
It is unknown whether febrile infants 29 to 60 days old with positive urinalysis results require routine lumbar punctures for evaluation of bacterial meningitis.
objectiveTo determine the prevalence of bacteremia and/or bacterial meningitis in febrile infants ≤60 days of age with positive urinalysis (UA) results.
methodsSecondary analysis of a prospective observational study of noncritical febrile infants ≤60 days between 2011 and 2019 conducted in the Pediatric Emergency Care Applied Research Network emergency departments. Participants had temperatures ≥38°C and were evaluated with blood cultures and had UAs available for analysis. We report the prevalence of bacteremia and bacterial meningitis in those with and without positive UA results.
resultsAmong 7180 infants, 1090 (15.2%) had positive UA results. The risk of bacteremia was higher in those with positive versus negative UA results (63/1090 [5.8%] vs 69/6090 [1.1%], difference 4.7% [3.3% to 6.1%]). There was no difference in the prevalence of bacterial meningitis in infants ≤28 days of age with positive versus negative UA results (∼1% in both groups). However, among 697 infants aged 29 to 60 days with positive UA results, there were no cases of bacterial meningitis in comparison to 9 of 4153 with negative UA results (0.2%, difference -0.2% [-0.4% to -0.1%]). In addition, there were no cases of bacteremia and/or bacterial meningitis in the 148 infants ≤60 days of age with positive UA results who had the Pediatric Emergency Care Applied Research Network low-risk blood thresholds of absolute neutrophil count <4 × 103 cells/mm3 and procalcitonin <0.5 ng/mL.
conclusionsAmong noncritical febrile infants ≤60 days of age with positive UA results, there were no cases of bacterial meningitis in those aged 29 to 60 days and no cases of bacteremia and/or bacterial meningitis in any low-risk infants based on low-risk blood thresholds in both months of life. These findings can guide lumbar puncture use and other clinical decision making.
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