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Predicting Serious Bacterial Infections Among Hypothermic Infants in the Emergency Department

Nathan M Money1, Yu Hsiang J Lo2, Hannah King3

  • 1Division of Pediatric Hospital Medicine, University of Utah School of Medicine, Salt Lake City, Utah.

Hospital Pediatrics
|February 5, 2024
PubMed

Insights

Hypothermic infants presenting to the emergency department (ED) with fever, leukocytosis, or abnormal urinalysis face a higher risk of serious bacterial infections (SBI). Further research is needed for definitive risk stratification.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Limited evidence exists for evaluating hypothermic infants.
  • Serious bacterial infections (SBI) pose a significant risk in this population.
  • Accurate risk assessment is crucial for timely intervention.

Purpose of the Study:

  • To identify risk factors for SBI in hypothermic infants.
  • To evaluate the utility of historical, physical examination, and laboratory data.
  • To inform clinical decision-making in the emergency department (ED).

Main Methods:

  • Multicenter case-control study.
  • Included hypothermic infants (rectal temperature <36.5°C) up to 90 days old.
  • Used logistic regression to identify risk factors for SBI (bacteremia, meningitis, UTI).

Main Results:

  • 6.1% of 934 infants had SBI.
  • Risk factors included: age >21 days, fever, leukocytosis, elevated absolute neutrophil count, thrombocytosis, and abnormal urinalysis.
  • Prematurity, respiratory distress, and home hypothermia were negatively associated with SBI.

Conclusions:

  • Historical, examination, and laboratory data can aid in risk stratification for SBI in hypothermic infants.
  • Abnormal urinalysis showed promise in a reduced model.
  • Larger studies are required for definitive risk stratification, especially for invasive bacterial infections.
Abstract

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