Predicting severe bacterial infections in well-appearing febrile neonates: laboratory markers accuracy and duration of fever

The Pediatric Infectious Disease Journal
Silvia BressanLiviana Da Dalt

Abstract

To assess the diagnostic accuracy of white blood cell count (WBC), absolute neutrophil count (ANC), and C-reactive protein (CRP) in detecting severe bacterial infections (SBI) in well-appearing neonates with early onset fever without source (FWS) and in relation to fever duration. An observational study was conducted on previously healthy neonates 7 to 28 days of age, consecutively hospitalized for FWS from less than 12 hours to a tertiary care Pediatric Emergency Department, over a 4-year period. Laboratory markers were obtained upon admission in all patients and repeated 6 to 12 hours from admission in those with normal values on initial determination. Sensitivity, specificity, positive and negative likelihood ratios, and receiver operating characteristic analysis were carried out for primary and repeated laboratory examinations. Ninety-nine patients were finally studied. SBI was documented in 25 (25.3%) neonates. Areas under receiver operating characteristic curves were 0.78 (95% CI, 0.69-0.86) for CRP, 0.77 (95% CI, 0.67-0.85) for ANC and 0.59 (95% CI, 0.49-0.69) for WBC. Sixty-two patients presented normal laboratory markers on initial determination. Of these, 58 successfully underwent repeated blood examination at >12 hou...Continue Reading

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Citations

Nov 19, 2013·DNA and Cell Biology·Christelle GabrielLisa F P Ng
Jan 3, 2012·The Pediatric Infectious Disease Journal·Silvia GarciaJavier Benito
Jan 1, 2012·Hospital Pediatrics·Joel S Tieder, Michelle Marks
Jul 7, 2015·Expert Review of Anti-infective Therapy·Sumita PaiSani H Aliyu
Mar 25, 2017·Journal of the Pediatric Infectious Diseases Society·Sharon B MeropolSara M Debanne
Jan 15, 2019·The Cochrane Database of Systematic Reviews·Jennifer Valeska Elli BrownWilliam McGuire
Dec 1, 2018·Archives of Disease in Childhood·Borja GomezSantiago Mintegi
Jun 21, 2014·Hemodialysis International·Lung-Wen TsaiChien-Tsai Liu
Oct 1, 2019·The Pediatric Infectious Disease Journal·Leire BonillaSantiago Mintegi
Jun 3, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Dyda DaoYves Ouellette
Jan 15, 2015·Hemodialysis International·Ming-Hsien TsaiShih-Chung Hsieh
Apr 3, 2020·Pediatrics in Review·Matthew D TaylorJoseph A Carcillo
Dec 22, 2010·Scandinavian Journal of Infectious Diseases·Efraim BilavskyGilat Livni
Nov 16, 2010·Expert Review of Anti-infective Therapy·Annick Galetto-Lacour, Alain Gervaix
Jun 14, 2017·Indian Pediatrics·UNKNOWN For Academic College of Emergency Experts in India (ACEE-INDIA) – INDO US Emergency and Trauma CollaborativeSagar Galwankar
Jul 7, 2016·Pediatrics·Borja GomezUNKNOWN European Group for Validation of the Step-by-Step Approach

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