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The changing epidemiology of serious bacterial infections in young infants

Tara L Greenhow1, Yun-Yi Hung, Arnd M Herz

  • 1From the *Division of Infectious Diseases, Department of Pediatrics, Kaiser Permanente Northern California, San Francisco; †Division of Research, Kaiser Permanente Northern California, Oakland; ‡Division of Infectious Diseases, Department of Pediatrics, Kaiser Permanente Northern California, Hayward; §Department of Pediatrics, Kaiser Permanente Northern California, Oakland; and ¶Department of Pediatrics, Division of General Pediatrics, University of California, San Francisco, CA.

The Pediatric Infectious Disease Journal
|December 12, 2013
PubMed

Insights

Urinary tract infections (UTIs) are now more common than bacteremia and meningitis in febrile infants. Prompt urinalysis is crucial for diagnosing these serious bacterial infections in young children.

Area of Science:

  • Pediatric infectious diseases
  • Neonatal and infant health
  • Clinical microbiology

Background:

  • Managing febrile infants with suspected serious bacterial infections presents ongoing challenges.
  • Population-based data on the impact of Group B Streptococcus screening and infant immunizations are limited.

Purpose of the Study:

  • To analyze the incidence and patterns of serious bacterial infections in full-term infants.
  • To evaluate the relative frequency of bacteremia, urinary tract infections (UTIs), and bacterial meningitis.

Main Methods:

  • Retrospective analysis of blood, urine, and cerebrospinal fluid cultures from full-term infants (1 week to 3 months).
  • Data collected over a 7-year period from electronic medical records at Kaiser Permanente Northern California.
  • Inclusion of 224,553 infants born during the study period.

Main Results:

  • Incidence rates: Bacteremia 2%, UTI 17%, bacterial meningitis 0.9%.
  • Overall serious bacterial infections: 3.75/1000 births; febrile serious bacterial infections: 3.1/1000 births.
  • Escherichia coli was the predominant pathogen for bacteremia, UTI, and meningitis. 92% of occult infections were associated with UTIs.

Conclusions:

  • Urinary tract infections are now significantly more prevalent than bacteremia and meningitis in febrile infants.
  • The findings underscore the critical importance of performing urinalysis in evaluating febrile infants for serious bacterial infections.
Abstract

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