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    Changing epidemiology of serious bacterial infections in febrile infants without localizing signs.

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    183.2 Kb
    Date
    2010-08-27
    Authors
    Watt, K
    Waddle, E
    Jhaveri, R
    Repository Usage Stats
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    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.
    Type
    Journal article
    Subject
    Age Distribution
    Ampicillin
    Anti-Bacterial Agents
    Bacterial Infections
    Drug Resistance, Bacterial
    Female
    Humans
    Infant
    Infant, Newborn
    Male
    Permalink
    http://hdl.handle.net/10161/4568
    Published Version (Please cite this version)
    10.1371/journal.pone.0012448
    Publication Info
    Watt, K; Waddle, E; & Jhaveri, R (2010). Changing epidemiology of serious bacterial infections in febrile infants without localizing signs. PLoS One, 5(8). pp. e12448. 10.1371/journal.pone.0012448. Retrieved from http://hdl.handle.net/10161/4568.
    This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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