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Updated: Feb 18, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Predictors of death in infants with probable serious bacterial infection
Prashant Singh1, Ananya Arora2, Tor A Strand3
1Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Insights
Infant deaths from serious bacterial infections are predicted by formula or cow
Area of Science:
- Neonatal and Infant Health
- Infectious Diseases
- Pediatric Critical Care
Background:
- Bacterial infections are a major cause of infant mortality worldwide.
- Serious bacterial infections pose a significant threat to neonates and infants.
- Identifying early predictors of mortality is crucial for timely intervention.
Purpose of the Study:
- To identify predictors of death in infants diagnosed with probable serious bacterial infection (PSBI).
- To analyze risk factors associated with mortality within 21 days of PSBI diagnosis.
- To inform clinical management strategies for high-risk infants with PSBI.
Main Methods:
- Secondary analysis of data from 700 infants with PSBI in a randomized controlled trial in India.
- Logistic regression modeling to assess associations between variables and 21-day mortality.
- Inclusion of clinical features and C-reactive protein (CRP) levels in the analysis.
Main Results:
- Feeding infants cow's milk or formula before illness increased odds of death (OR 3.7-5.3).
- Lethargy (OR 2.4) and elevated CRP levels (OR 1.9) were independent predictors of death.
- Clinical signs like abdominal distention and bulging fontanelle also predicted mortality.
Conclusions:
- Formula or cow milk feeding prior to illness is a significant risk factor for infant mortality in PSBI.
- Lethargy and high C-reactive protein levels are critical indicators of poor prognosis in infants with PSBI.
- Early identification of these predictors can guide prompt medical attention and improve outcomes for infants with serious bacterial infections.
Abstract:
BackgroundBacterial infections account for a significant proportion of neonatal and infant mortality globally. We aimed to identify predictors of death in infants with probable serious bacterial infection (PSBI) defined as signs/symptoms of possible serious bacterial infection along with baseline C-reactive protein (CRP) ≥12 mg/l.MethodsWe did a secondary analysis using the data collected from 700 infants with PSBI who participated in a randomized controlled trial in India in which zinc or placebo was given in addition to the standard antibiotics. Logistic regression was used to estimate the associations between relevant variables and death within 21 days.ResultsThose infants who were fed cow's milk or formula before the illness episode had 3.7-fold (95% confidence interval (CI) 1.5-9.3) and 5.3-fold (95% CI 2.0-13.6) higher odds of death, respectively. Lethargy (odds ratio (OR) 2.4, 95% CI 1.1-5.4) and CRP (OR 1.9, 95% CI 1.1-3.3) were also independent predictors of death. In the model including only clinical features, female gender (OR 2.25, 95% CI 1.0-5.0), abdominal distention (3.7, 95% CI 1.1-12.3), and bulging fontanelle (5.8, 95% CI 1.1-30.5) were also independent predictors for death.ConclusionFormula or cow milk feeding prior to the illness, lethargy at the time of presentation, and high serum CRP levels predicted death in infants with PSBI.
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