Febrile Infants - Diagnostic Assessment and Outcome

Conditions

Bacterial Infections, Meningitis, Bacterial, Urinary Tract Infections

Brief summary

The purpose of this study is to assess how clinicians apply guidance in the assessment of febrile infants presenting the the Emergency Department. The measurable outcomes are: Primary Objective Report the rates of serious and invasive bacterial infections in febrile infants Secondary Objectives Report on the predictive value of different clinical features for predicting bacterial infections. Report on the value of biomarkers for predicting serious and invasive bacterial infections. Assess the performance of clinical practice guidelines for the assessment of febrile infants.

Detailed description

The assessment of febrile infants is difficult. In the UK and Ireland current guidance advocates that most children under 3 months of age with a fever undergo a full septic screen including lumbar puncture and receive parenteral antibiotics. Approaches in the United States and Europe including the PECARN and StepByStep approach allow for the discharge home of some low risk young infants. We intend to assess the current approach to febrile infants and compare that to the available clinical practice guidelines. We also intend to determine which clinical and/or laboratory features are most predictive of serious bacterial infection.

Thomas Waterfield, Steven Foster, Rebecca Platt, Michael Barrett, Sheena Durnin et al. (11 authors)

Archives of Disease in Childhood2022-08-2412 citations

10.1136/archdischild-2022-324300

979 A International Multicentre observational study to validate clinical practice guidelines for management of febrile infants aged ≤90 days

Deepika Subrahmanyam Puthucode, Marc McNulty, Thomas Waterfield

Abstracts2021-09-30

10.1136/archdischild-2021-rcpch.315

Validating clinical practice guidelines for the management of febrile infants presenting to the emergency department in the UK and Ireland

Thomas Waterfield, Mark D Lyttle, Charlotte Munday, Steven Foster, Marc McNulty et al. (16 authors)

Archives of Disease in Childhood2021-09-1624 citations

10.1136/archdischild-2021-322586

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

No minimum to 90 Days

Inclusion criteria

* Any infant aged 0 to 90 days (inclusive) with a fever of 38 degrees centigrade or higher recorded in the Emergency Department.

Design outcomes

Primary

Measure	Time frame	Description
Invasive bacterial infection	seven days	Invasive Bacterial Infection (non-contaminant) confirmed by culture or molecular diagnostic testing of a sterile site i.e. blood or cerebrospinal fluid (CSF). Staphylococcus epidermidis, Propionibacterium acnes, Streptococcus viridans, or Diphtheroides were considered contaminants.
Serious bacterial infections	seven days	Urinary tract infections defined as growth of ≥100 000 cfu/mL

Countries

Ireland, United Kingdom

Outcome results