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Delayed presentation is associated with serious bacterial infections among febrile infants: A prospective cohort study.
Rajoo, Karthigha Pon; Sutiman, Natalia; Shih, Stephanie; Khoo, Zi Xean; Ong, Gene Yong-Kwang; Wong, Lena; Piragasam, Rupini; Ganapathy, Sashikumar; Chong, Shu-Ling.
Afiliação
  • Rajoo KP; Department of Children's Emergency, KK Women's and Children's Hospital, Singapore.
  • Sutiman N; Department of Children's Emergency, KK Women's and Children's Hospital, Singapore.
  • Shih S; Barts and the London School of Medicine and Dentistry, Queen Mary University of London.
  • Khoo ZX; Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
  • Ong GY; SingHealth-Duke NUS Paediatrics Academic Clinical Programme, Duke-NUS Medical School, Singapore.
  • Wong L; Department of Children's Emergency, KK Women's and Children's Hospital, Singapore.
  • Piragasam R; SingHealth-Duke NUS Paediatrics Academic Clinical Programme, Duke-NUS Medical School, Singapore.
  • Ganapathy S; SingHealth-Duke NUS Emergency Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore.
  • Chong SL; KK Research Centre, KK Women's and Children's Hospital, Singapore.
Ann Acad Med Singap ; 53(5): 286-292, 2024 May 10.
Article em En | MEDLINE | ID: mdl-38920220
ABSTRACT

Introduction:

Febrile young infants are at risk of serious bacterial infections (SBIs), which are potentially life-threatening. This study aims to investigate the association between delayed presentation and the risk of SBIs among febrile infants.

Method:

We performed a prospective cohort study on febrile infants ≤90 days old presenting to a Singapore paediatric emergency department (ED) between November 2017 and July 2022. We defined delayed presentation as presentation to the ED >24 hours from fever onset. We compared the proportion of SBIs in infants who had delayed presentation compared to those without, and their clinical outcomes. We also performed a multivariable logistic regression to study if delayed presentation was independently associated with the presence of SBIs.

Results:

Among 1911 febrile infants analysed, 198 infants (10%) had delayed presentation. Febrile infants with delayed presentation were more likely to have SBIs (28.8% versus [vs] 16.3%, P<0.001). A higher proportion of infants with delayed presentation required intravenous antibiotics (64.1% vs 51.9%, P=0.001). After adjusting for age, sex and severity index score, delayed presentation was independently associated with the presence of SBI (adjusted odds ratio [AOR] 1.78, 95% confidence interval 1.26-2.52, P<0.001).

Conclusion:

Febrile infants with delayed presentation are at higher risk of SBI. Frontline clinicians should take this into account when assessing febrile infants.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Infecções Bacterianas / Serviço Hospitalar de Emergência / Febre / Antibacterianos Limite: Female / Humans / Infant / Male / Newborn País/Região como assunto: Asia Idioma: En Revista: Ann Acad Med Singap Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Singapura

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Infecções Bacterianas / Serviço Hospitalar de Emergência / Febre / Antibacterianos Limite: Female / Humans / Infant / Male / Newborn País/Região como assunto: Asia Idioma: En Revista: Ann Acad Med Singap Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Singapura