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A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
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Neonatal Mastitis and Concurrent Serious Bacterial Infection
Ron L Kaplan1, Andrea T Cruz2, Kenneth A Michelson3
1Department of Pediatrics, School of Medicine, University of Washington and Seattle Children's Hospital, Seattle, Washington ron.kaplan@seattlechildrens.org.
Pediatrics
|June 30, 2021
Summary
Neonatal mastitis typically presents as mild, localized disease. Serious bacterial infections (SBI) and adverse outcomes are rare, suggesting SBI evaluation may be unnecessary for well-appearing, afebrile infants.
Area of Science:
- Pediatric Emergency Medicine
- Neonatology
- Infectious Diseases
Background:
- Neonatal mastitis is a condition affecting infants, with potential for concurrent serious bacterial infections (SBI).
- Understanding the clinical presentation, prevalence, and outcomes of SBI in infants with mastitis is crucial for appropriate management.
Purpose of the Study:
- To describe the clinical presentation, prevalence, and outcomes of concurrent serious bacterial infection (SBI) among infants diagnosed with mastitis.
- To determine if routine evaluation for SBI is necessary in infants presenting with mastitis.
Main Methods:
- A multicenter retrospective cohort study was conducted involving 28 sites.
- Records of infants aged ≤90 days with mastitis seen in the emergency department between January 2008 and December 2017 were reviewed.
- Demographic, clinical, laboratory, treatment, and outcome data were collected and summarized.
Main Results:
- Among 657 infants, 98% were well-appearing. Pathogen growth was rare in blood (0.3%), urine (1.1%), and cerebrospinal fluid (0.4%) cultures.
- Methicillin-resistant Staphylococcus aureus was the most common pathogen (54%) in cultures from the site of infection.
- Serious bacterial infections (sepsis, shock, severe cellulitis) occurred in 1.5% of infants, with no deaths.
Conclusions:
- Neonatal mastitis is typically a mild, localized condition.
- Serious bacterial infections and adverse outcomes are infrequent in infants with mastitis.
- Routine evaluation for SBI may not be necessary for afebrile, well-appearing infants with mastitis.
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