지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.12
- 수록면
- 67 - 74 (8page)
- DOI
- https://doi.org/10.22470/pemj.2017.00129
이용수
초록· 키워드
오류제보하기
Purpose
To retrospectively validate the Step-by-Step approach, a sequential algorithm for prediction of serious bacterial infections (SBI) using the appearance, age, and inflammatory markers, in febrile infants younger than 90 days.
Methods
The presence of SBI was reviewed in febrile infants younger than 90 days undergoing blood and urine cultures (using perineal adhesive bags), assays for procalcitonin, C-reactive protein and absolute neutrophil count, and urinalysis at the emergency department from September 2015 through August 2017. The low-risk infants were classified according to the Step-by-Step approach. SBI was defined as urinary tract infection (UTI), bacteremia or meningitis. We measured the sensitivity and negative predictive value (NPV) of the approach in predicting SBI, and compared the values to those of the Rochester criteria and the Lab-score.
Results
Of 488 febrile infants (44.7% underwent lumbar puncture), 71 (14.5%) had SBI, including 67 UTI, 5 bacteremia, and 3 meningitis (mutually inclusive). Of 208 low-risk infants (42.6%), no SBI was found. The Step-by-Step approach showed a 100% sensitivity (95% confidence interval [CI]: 94.9-100.0) and NPV (95% CI: not applicable). The Rochester criteria showed a 98.6% sensitivity (95% CI: 92.4-100.0) and 99.6% NPV (95% CI: 97.1-99.9), and missed 1 meningitis. The Lab-score showed a 59.2% sensitivity (95% CI: 46.8-70.7) and 93.2% NPV (95% CI: 91.2-94.8), and missed 2 meningitis and 27 UTI.
Conclusion
The Step-by-Step approach showed a 100% sensitivity and NPV in predicting SBI. This approach may help predict SBI without lumbar puncture in febrile infants younger than 90 days.
목차
등록된 정보가 없습니다.
참고문헌 (20)
참고문헌 신청
Baker MD / 1993 / Outpatient management without antibiotics of fever in selected infants / N Engl J Med 329:1437~141
Greenhow TL / 2016 / Management and outcomes of previously healthy, full-term, febrile infants ages 7 to 90 days / Pediatrics 138:e20160270
Greenhow TL / 2017 / Bacteremia in children 3 to 36 months old after introduction of conjugated pneumococcal vaccines / Pediatrics 139:e20162098
Greenhow TL / 2014 / The changing epidemiology of serious bacterial infections in young infants / Pediatr Infect Dis J 33:595~599
Chua KP / 2015 / Association between clinical outcomes and hospital guidelines for cerebrospinal fluid testing in febrile infants aged 29-56days / J Pediatr 167:1340~1346.e9
Greenhow TL / 2016 / Management and outcomes of previously healthy, full-term, febrile infants ages 7 to 90 days / Pediatrics 138:e20160270
Greenhow TL / 2017 / Bacteremia in children 3 to 36 months old after introduction of conjugated pneumococcal vaccines / Pediatrics 139:e20162098
Greenhow TL / 2014 / The changing epidemiology of serious bacterial infections in young infants / Pediatr Infect Dis J 33:595~599
Chua KP / 2015 / Association between clinical outcomes and hospital guidelines for cerebrospinal fluid testing in febrile infants aged 29-56days / J Pediatr 167:1340~1346.e9
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