Assessment of Febrile Neonates According to Low Risk Criteria for Serious Bacterial Infection

AUTHORS

Tahereh Rostami 1 , Mohammad Momtazbakhsh 1 , Houman Hashemian 1 , Marjaneh Zarkesh 2 , *

1 Department of Pediatrics, 17 Shahrivar Children's Hospital, Guilan University of Medical Sciences, Rasht, Iran

2 Department of Pediatrics, 17 Shahrivar Children's Hospital, Guilan University of Medical Sciences, Rasht,, Iran

How to Cite: Rostami T, Momtazbakhsh M, Hashemian H, Zarkesh M. Assessment of Febrile Neonates According to Low Risk Criteria for Serious Bacterial Infection, Iran J Pediatr. 2011 ; 21(4):436-440.

ARTICLE INFORMATION

Iranian Journal of Pediatrics: 21 (4); 436-440
Published Online: December 31, 2011
Article Type: Research Article
Received: May 29, 2010
Accepted: February 11, 2011

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Abstract

Objective: It is propounded that febrile neonates with low risk criteria (LRC) can be carefully observed without parenteral antimicrobial therapy; but yet, reliability of LRC to exclude serious bacterial infection (SBI) is uncertain.
Methods: The records of all febrile term neonates, seen in the emergency room and admitted in neonatal ward of 17 Shahrivar children's hospital of Rasht, Iran from January 2004 to January 2009 were reviewed. All of them underwent full sepsis workup. The prevalence of SBI in total population and LRC positive and negative neonates were calculated
Findings: A total of 202 records of previously healthy febrile neonates were evaluated. SBI was shown in 38 (18.8%). The most common type of SBI was urinary tract infection (UTI). Sixty-two (31%) neonates had LRC, and only one (1.6%) had SBI (UTI with E. coli). SBI was significantly more common in neonates without LRC (26.6% versus 1.6%, P<0.001). The negative predictive value (NPV) of LRC to exclude SBI was 98.4% (95%confidence interval: 96.7% to 100%).
Conclusion: These findings suggest that LRC may be relied upon to exclude SBI in febrile neonates. We propose that all febrile neonates be admitted, ill or LRC negative neonates should undergo a full sepsis work up and be administered systemic antibiotics immediately. LRC positive neonates should be under close observation.

 

Keywords

Low-risk criteria Neonate Serious bacterial infection

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