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dc.contributor.author Watt, K
dc.contributor.author Waddle, E
dc.contributor.author Jhaveri, R
dc.coverage.spatial United States
dc.date.accessioned 2011-06-21T17:32:13Z
dc.date.issued 2010-08-27
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/20805983
dc.identifier.citation PLoS One, 2010, 5 (8), pp. e12448 - ?
dc.identifier.uri http://hdl.handle.net/10161/4568
dc.description.abstract OBJECTIVE: Historically, management of infants with fever without localizing signs (FWLS) has generated much controversy, with attempts to risk stratify based on several criteria. Advances in medical practice may have altered the epidemiology of serious bacterial infections (SBIs) in this population. We conducted this study to test the hypothesis that the rate of SBIs in this patient population has changed over time. PATIENTS AND METHODS: We performed a retrospective review of all infants meeting FWLS criteria at our institution from 1997-2006. We examined all clinical and outcome data and performed statistical analysis of SBI rates and ampicillin resistance rates. RESULTS: 668 infants met criteria for FWLS. The overall rate of SBIs was 10.8%, with a significant increase from 2002-2006 (52/361, 14.4%) compared to 1997-2001 (20/307, 6.5%) (p = 0.001). This increase was driven by an increase in E. coli urinary tract infections (UTI), particularly in older infants (31-90 days). CONCLUSIONS: We observed a significant increase in E. coli UTI among FWLS infants with high rates of ampicillin resistance. The reasons are likely to be multifactorial, but the results themselves emphasize the need to examine urine in all febrile infants <90 days and consider local resistance patterns when choosing empiric antibiotics.
dc.format.extent e12448 - ?
dc.language eng
dc.language.iso en_US en_US
dc.relation.ispartof PLoS One
dc.relation.isversionof 10.1371/journal.pone.0012448
dc.subject Age Distribution
dc.subject Ampicillin
dc.subject Anti-Bacterial Agents
dc.subject Bacterial Infections
dc.subject Drug Resistance, Bacterial
dc.subject Female
dc.subject Humans
dc.subject Infant
dc.subject Infant, Newborn
dc.subject Male
dc.title Changing epidemiology of serious bacterial infections in febrile infants without localizing signs.
dc.title.alternative en_US
dc.type Journal Article
dc.description.version Version of Record en_US
duke.date.pubdate 2010-8-27 en_US
duke.description.endpage e12448 en_US
duke.description.issue 8 en_US
duke.description.startpage e12448 en_US
duke.description.volume 5 en_US
dc.relation.journal Plos One en_US
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/20805983
pubs.issue 8
pubs.organisational-group /Duke
pubs.organisational-group /Duke/School of Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Pediatrics
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Pediatrics/Pediatrics, Critical Care Medicine
pubs.organisational-group /Duke/School of Medicine/Institutes and Centers
pubs.organisational-group /Duke/School of Medicine/Institutes and Centers/Duke Clinical Research Institute
pubs.publication-status Published online
pubs.volume 5
dc.identifier.eissn 1932-6203

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