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Infections in hypothermic infants younger than 3 months old
Insights
Infants with hypothermia (low body temperature) often have infections, leading to worse outcomes. Early antibiotic treatment is recommended for infants under 3 months with hypothermia due to a lack of quick diagnostic indicators.
Area of Science:
- Pediatrics
- Neonatology
- Infectious Diseases
Background:
- Hypothermia in infants is linked to significant illness and death.
- Infection is common in hypothermic infants and associated with poor prognosis.
Purpose of the Study:
- To investigate the association between infection and clinical variables in hypothermic infants.
- To evaluate morbidity and mortality in infected versus non-infected hypothermic infants.
- To identify reliable indicators for infection in hypothermic infants.
Main Methods:
- Retrospective review of medical records for 51 infants (under 3 months) hospitalized with hypothermia (rectal temperature ≤34°C).
- Analysis of clinical data, including vital signs, laboratory results, and presence of infection.
Main Results:
- Infections were diagnosed in 27 of 51 infants.
- Infection was significantly associated with bradycardia, anemia, abnormal leukocyte counts, abnormal serum glucose, and uremia (especially with ≥2 variables).
- Morbidity and mortality were higher in infected infants.
Conclusions:
- No rapid, reliable indicators for infection in hypothermic infants were identified.
- Antibiotic administration is suggested for all infants under 3 months with hypothermia upon hospital admission pending improved diagnostic methods.
Abstract:
Hypothermia in infants is associated with considerable morbidity and mortality. Infection is thought to occur frequently and to carry a poor prognosis in infants with hypothermia. The medical records of 51 infants less than 3 months of age hospitalized from 1976 through 1981 with rectal temperatures of 34 degrees C or less were reviewed. Infections were diagnosed in 27 of the 51 infants. Infections were associated significantly with the presence of bradycardia, anemia, abnormal leukocyte counts, abnormal serum glucose levels, and uremia, especially if two or more of these variables were present. Morbidity and mortality were higher among infected than among noninfected infants. No rapid reliable indicators for the presence or absence of infection in an individual infant with hypothermia were found despite the differences noted between the two groups. Until new techniques for the detection of bacterial infections became available, we suggest that antibiotics be given to all infants younger than 3 months of age with hypothermia on admission to the hospital.