Powell EC, et al. - This study aimed at describing the current epidemiology of bacteremia in febrile infants 60 days of age and younger in the Pediatric Emergency Care Applied Research Network (PECARN). Among febrile infants 28 days of age and younger, a high prevalence of bacteremia and meningitis was observed and exceeded that observed in infants aged 29 to 60 days. E coli and group B streptococcus were identified as the most common bacterial pathogens.

Methods

• A planned secondary analysis was performed of a prospective observational study of febrile infants 60 days of age and younger presenting to any of 26 PECARN emergency departments (2008 to 2013) who had blood cultures obtained.
• Infants with significant comorbidities or critically ill appearance were excluded.
• For this study, the primary outcome was prevalence of bacteremia.

Results

• 7,335 infants were screened; 4,778 (65.1%) of these had blood cultures and were enrolled.
• 84 of the enrolled infants had bacteremia (1.8%; 95% confidence interval [CI] 1.4% to 2.2%).
• In infants aged 28 days or younger, the prevalence of bacteremia (47/1,515) was 3.1% (95% CI 2.3% to 4.1%); in infants aged 29 to 60 days (37/3,246), was 1.1% (95% CI 0.8% to 1.6%).
• For infants 28 days of age and younger, prevalence differed by week of age (0 to 7 days: 4/156, 2.6%; 8 to 14 days: 19/356, 5.3%; 15 to 21 days: 15/449, 3.3%; and 22 to 28 days: 9/554, 1.6%).
• Escherichia coli (39.3%; 95% CI 29.5% to 50.0%) and group B streptococcus (23.8%; 95% CI 16.0% to 33.9%) were the most common pathogens identified.
• Researchers noticed bacterial meningitis in 19 of 1,515 infants 28 days of age and younger (1.3%; 95% CI 0.8% to 2.0%) and 5 of 3,246 infants aged 29 to 60 days (0.2%; 95% CI 0.1% to 0.4%).
• Of 84 infants with bacteremia, 36 (42.9%; 95% CI 32.8% to 53.5%) indicated urinary tract infections (E coli 83%); 11 (13.1%; 95% CI 7.5% to 21.9%) indicated bacterial meningitis.