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Serious Bacterial Infections in Preterm Infants: Should Their Age Be "Corrected"?

Mohamad Hadhud1, Itai Gross2,3, Noa Hurvitz1

  • 1Department of Pediatrics, Hadassa-Hebrew University Medical Center, Hebrew University of Jerusalem, Jerusalem 91120, Israel.

Journal of Clinical Medicine
|May 13, 2023
PubMed

Insights

Corrected age is crucial for assessing serious bacterial infections (SBI) in preterm infants. Preterm infants under 3 months corrected age show a higher SBI risk, similar to term infants, highlighting the need for age correction in fever assessments.

Area of Science:

  • Neonatal Medicine
  • Pediatric Infectious Diseases
  • Neurodevelopmental Pediatrics

Background:

  • Adjusting preterm infant age for neurodevelopmental assessments is standard practice.
  • The validation of using corrected age for assessing serious bacterial infection (SBI) in preterm infants is limited.
  • Accurate age assessment is critical, particularly for infants over 3 months chronological age but under 3 months corrected age.

Purpose of the Study:

  • To evaluate the difference in serious bacterial infection (SBI) incidence in preterm infants based on chronological versus corrected age.
  • To determine if corrected age impacts the risk assessment for SBI in preterm infants presenting with fever.
  • To compare SBI risk in preterm infants with corrected age <3 months to that of term infants <3 months.

Main Methods:

  • Retrospective analysis of pediatric emergency department (PED) presentations for 448 preterm infants born between 2010 and 2019.
  • Inclusion criteria: preterm infants presenting with fever within their first year of life.
  • Infants categorized into three groups based on chronological and corrected age: corrected age >3 months; chronological age >3 months/corrected age <3 months; chronological and corrected age <3 months.

Main Results:

  • Serious bacterial infection (SBI) incidence was 2.6% in preterm infants with corrected age >3 months.
  • SBI incidence was 16.7% in preterm infants with chronological age >3 months but corrected age <3 months.
  • SBI incidence was 33.3% in preterm infants with both chronological and corrected age <3 months (p < 0.001).
  • The control group of 300 term infants <3 months had an SBI incidence of 15.3%.

Conclusions:

  • Preterm infants with a corrected age under 3 months face an elevated risk of serious bacterial infection (SBI).
  • This increased risk is comparable to that observed in term infants under 3 months of age.
  • Age correction is recommended for preterm infants presenting with fever to accurately assess SBI risk.

Keywords:
corrected ageemergency medicineex-premature infantspremature infantsserious bacterial infection

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