Prevalence of Serious Bacterial Infection in Young Infants with Hypothermia with Positive Respiratory Pathogen Testing

Madhuri Prasad, MD; John M. Morrison, MD, PhD; Sumeet L. Banker, MD, MPH; Jennifer Lee, MD; Julie K. Wood, DO; Annalise Van Meurs, MD; Kathryn Westphal, MD; Emma Schwendeman, MD; Stephanie Berger, MD; Elizabeth O. Mertens, MD; Saylor McCartor, DO; Meredith Mitchell, MD; Clifton Lee, MD; Monica D. Combs, MD; Kira Molas-Torreblanca, DO, MPH; Joseph A. Ewing, PhD; Elizabeth E. Halvorson, MD, MS; Nicholas M. Potisek, MD; Sanford Williams, MD; Jennifer Raffaele, MD; Vignesh Dorsaiswamy, MD; Evan Ingram, MD; Meenu Sharma, DO

Journal of Pediatrics: Clinical Practice (Jun 2024)

Prevalence of Serious Bacterial Infection in Young Infants with Hypothermia with Positive Respiratory Pathogen Testing

Madhuri Prasad, MD,
John M. Morrison, MD, PhD,
Sumeet L. Banker, MD, MPH,
Jennifer Lee, MD,
Julie K. Wood, DO,
Annalise Van Meurs, MD,
Kathryn Westphal, MD,
Emma Schwendeman, MD,
Stephanie Berger, MD,
Elizabeth O. Mertens, MD,
Saylor McCartor, DO,
Meredith Mitchell, MD,
Clifton Lee, MD,
Monica D. Combs, MD,
Kira Molas-Torreblanca, DO, MPH,
Joseph A. Ewing, PhD,
Elizabeth E. Halvorson, MD, MS,
Nicholas M. Potisek, MD,
Sanford Williams, MD,
Jennifer Raffaele, MD,
Vignesh Dorsaiswamy, MD,
Evan Ingram, MD,
Meenu Sharma, DO

Affiliations

Madhuri Prasad, MD: Division of Pediatric Hospital Medicine, Johns Hopkins All Children’s Hospital, St Petersburg, FL
John M. Morrison, MD, PhD: Division of Pediatric Hospital Medicine, Johns Hopkins All Children’s Hospital, St Petersburg, FL; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD; Reprint requests: John Morrison, MD, PhD, Johns Hopkins All Children’s Hospital, 600 Fifth Street South, Suite 3200, Saint Petersburg, FL 33701.
Sumeet L. Banker, MD, MPH: Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY; Department of Pediatrics, New York Presbyterian Hospital-Morgan Stanley Children’s Hospital, New York, NY
Jennifer Lee, MD: Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY; Department of Pediatrics, New York Presbyterian Hospital-Morgan Stanley Children’s Hospital, New York, NY
Julie K. Wood, DO: Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC
Annalise Van Meurs, MD: Department of Pediatrics, Oregon Health and Science University, Doernbecher Children’s Hospital, Portland, OR
Kathryn Westphal, MD: Division of Hospital Medicine, Nationwide Children’s Hospital, Columbus, OH; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH
Emma Schwendeman, MD: Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH
Stephanie Berger, MD: Department of Pediatrics, University of Alabama Heersink School of Medicine, Birmingham, AL
Elizabeth O. Mertens, MD: Department of Pediatrics, University of Alabama Heersink School of Medicine, Birmingham, AL
Saylor McCartor, DO: Department of Pediatrics, University of South Carolina of Medicine – Greenville, Prisma Children’s Health Hospital – Upstate, Greenville, SC
Meredith Mitchell, MD: Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
Clifton Lee, MD: Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
Monica D. Combs, MD: Department of Pediatrics, Keck School of Medicine of University of Southern California, Children’s Hospital Los Angeles, Los Angeles, CA
Kira Molas-Torreblanca, DO, MPH: Department of Pediatrics, Keck School of Medicine of University of Southern California, Children’s Hospital Los Angeles, Los Angeles, CA
Joseph A. Ewing, PhD: Department of Pediatrics, University of South Carolina of Medicine – Greenville, Prisma Children’s Health Hospital – Upstate, Greenville, SC
Elizabeth E. Halvorson, MD, MS: Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC
Nicholas M. Potisek, MD: Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Pediatrics, University of South Carolina of Medicine – Greenville, Prisma Children’s Health Hospital – Upstate, Greenville, SC
Sanford Williams, MD
Jennifer Raffaele, MD
Vignesh Dorsaiswamy, MD
Evan Ingram, MD
Meenu Sharma, DO

Journal volume & issue: Vol. 12
p. 200095

Abstract

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Objectives: We sought to compare the prevalence of serious bacterial infections (SBI; urinary tract infection, bacteremia, and/or meningitis) and invasive bacterial infections (IBI; bacteremia and/or meningitis) among infants with hypothermia with positive vs negative respiratory pathogen testing. Study design: We conducted a multicenter retrospective cohort study of infants ≤90 days presenting to an emergency department or directly admitted to a hospital from September 1, 2016, to May 5, 2021, with reported or documented hypothermia (≤36°C). Positive respiratory pathogen testing included positive single or multiplex nucleic acid amplification testing. The primary outcome was prevalence of SBI, defined as positive blood, urine, and/or cerebrospinal fluid culture and antibiotic treatment course; the prevalence of SBI and IBI was compared between infants with positive vs negative respiratory pathogen tests using the χ2 test. Results: Respiratory pathogen testing was obtained in 40.6% (446/1098) of infants with hypothermia; of those, 24.9% (111/446) had a positive respiratory pathogen result. Infants with a positive respiratory pathogen result were more often older, ill-appearing at presentation, and evaluated during fall/winter months. The prevalence of SBI in our cohort was 7.4%, and the prevalence of IBI was 4.5%. There were no associations between respiratory pathogen test result and SBI or IBI. Conclusions: Most young infants with hypothermia evaluated did not have respiratory pathogen testing performed. The diagnosis of SBI or IBI was not associated with a positive respiratory pathogen test. Further research is needed to understand the utility of respiratory pathogen testing in risk stratification for infants with hypothermia.

Published in Journal of Pediatrics: Clinical Practice

ISSN: 2950-5410 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Pediatrics
Website: https://www.sciencedirect.com/journal/the-journal-of-pediatrics-clinical-practice

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