TY - JOUR
T1 - Prevalence of Invasive Bacterial Infection in Hypothermic Young Infants
T2 - A Multisite Study
AU - Hypothermic Young Infant Research Collaborative
AU - Raffaele, Jennifer L.
AU - Sharma, Meenu
AU - Berger, Stephanie
AU - Mitchell, Meredith
AU - Lee, Clifton
AU - Morrison, John
AU - Prasad, Madhuri
AU - Combs, Monica D.
AU - Molas-Torreblanca, Kira
AU - Wood, Julie K.
AU - Van Meurs, Annalise
AU - Westphal, Kathryn
AU - Sawani, Ali
AU - Banker, Sumeet L.
AU - Lee, Jennifer
AU - King, Coleton
AU - Halvorson, Elizabeth E.
AU - Potisek, Nicholas M.
AU - McCartor, Saylor
AU - Doraiswamy, Vignesh
AU - Williams, Sanford
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/7
Y1 - 2023/7
N2 - Objective: To determine the prevalence of bacteremia and meningitis (invasive bacterial infection [IBI]) in hypothermic young infants, and also to determine the prevalence of serious bacterial infections (SBI) and neonatal herpes simplex virus and to identify characteristics associated with IBI. Study design: We conducted a retrospective cohort study of infants ≤90 days of age who presented to 1 of 9 hospitals with historical or documented hypothermia (temperature ≤36.0°C) from September 1, 2017, to May 5, 2021. Infants were identified by billing codes or electronic medical record search of hypothermic temperatures. All charts were manually reviewed. Infants with hypothermia during birth hospitalization, and febrile infants were excluded. IBI was defined as positive blood culture and/or cerebrospinal fluid culture treated as a pathogenic organism, whereas SBI also included urinary tract infection. We used multivariable mixed-effects logistic regression to identify associations between exposure variables and IBI. Results: Overall, 1098 young infants met the inclusion criteria. IBI prevalence was 2.1% (95% CI, 1.3-2.9) (bacteremia 1.8%; bacterial meningitis 0.5%). SBI prevalence was 4.4% (95% CI, 3.2-5.6), and neonatal herpes simplex virus prevalence was 1.3% (95% CI, 0.6-1.9). Significant associations were found between IBI and repeated temperature instability (OR, 4.9; 95% CI, 1.3-18.1), white blood cell count abnormalities (OR, 4.8; 95% CI, 1.8-13.1), and thrombocytopenia (OR, 5.0; 95% CI, 1.4-17.0). Conclusions: IBI prevalence in hypothermic young infants is 2.1%. Further understanding of characteristics associated with IBI can guide the development decision tools for management of hypothermic young infants.
AB - Objective: To determine the prevalence of bacteremia and meningitis (invasive bacterial infection [IBI]) in hypothermic young infants, and also to determine the prevalence of serious bacterial infections (SBI) and neonatal herpes simplex virus and to identify characteristics associated with IBI. Study design: We conducted a retrospective cohort study of infants ≤90 days of age who presented to 1 of 9 hospitals with historical or documented hypothermia (temperature ≤36.0°C) from September 1, 2017, to May 5, 2021. Infants were identified by billing codes or electronic medical record search of hypothermic temperatures. All charts were manually reviewed. Infants with hypothermia during birth hospitalization, and febrile infants were excluded. IBI was defined as positive blood culture and/or cerebrospinal fluid culture treated as a pathogenic organism, whereas SBI also included urinary tract infection. We used multivariable mixed-effects logistic regression to identify associations between exposure variables and IBI. Results: Overall, 1098 young infants met the inclusion criteria. IBI prevalence was 2.1% (95% CI, 1.3-2.9) (bacteremia 1.8%; bacterial meningitis 0.5%). SBI prevalence was 4.4% (95% CI, 3.2-5.6), and neonatal herpes simplex virus prevalence was 1.3% (95% CI, 0.6-1.9). Significant associations were found between IBI and repeated temperature instability (OR, 4.9; 95% CI, 1.3-18.1), white blood cell count abnormalities (OR, 4.8; 95% CI, 1.8-13.1), and thrombocytopenia (OR, 5.0; 95% CI, 1.4-17.0). Conclusions: IBI prevalence in hypothermic young infants is 2.1%. Further understanding of characteristics associated with IBI can guide the development decision tools for management of hypothermic young infants.
UR - http://www.scopus.com/inward/record.url?scp=85159682597&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85159682597&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2023.113407
DO - 10.1016/j.jpeds.2023.113407
M3 - Article
C2 - 37023947
AN - SCOPUS:85159682597
SN - 0022-3476
VL - 258
JO - Journal of Pediatrics
JF - Journal of Pediatrics
M1 - 113407
ER -