title: Occurrence of serious bacterial infection in infants aged 60 days or younger with an apparent life-threatening event.
abstract: OBJECTIVE
  To describe the occurrence of serious bacterial infections (SBIs) in well-appearing, afebrile infants aged 60 days or younger with an apparent life-threatening event (ALTE).
  
  
  METHODS
  We retrospectively reviewed microbiologic testing in a cohort of well-appearing, afebrile infants aged 60 days or younger who presented with an ALTE to a children's hospital emergency department between January 2002 and July 2005. All patients were admitted and followed up for 6 months. Comparisons were made among those who did and did not undergo microbiologic testing and full sepsis evaluation (blood, urine, and cerebrospinal fluid) and those who did and did not have an SBI.
  
  
  RESULTS
  Of 182 patients, 112 (61.5%) underwent microbiologic testing, and 53 (29.1%) had a full sepsis evaluation. Five patients (2.7%; 95% confidence interval, 0.9%-6.3%) had an SBI including 3 positive results in blood cultures, 1 positive result in urine culture, and 1 positive result for pertussis by polymerase chain reaction. No patient had a positive result in cerebrospinal fluid culture (95% confidence interval, 0%-5.7%). Patients with a history of prematurity were more likely to have an SBI (6.7% vs. 0.8%, P = 0.04).
  
  
  CONCLUSIONS
  Serious bacterial infection occurred in 2.7% of well-appearing, afebrile infants aged 60 days or younger with an ALTE. Prematurity was associated with having an SBI. For premature infants aged 60 days or younger who present with an ALTE, an evaluation for SBI should be strongly considered.
authors.affiliation: Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh 15213, USA. zuckns@chp.edu
authors.forename: Noel S
authors.initials: NS
authors.lastname: Zuckerbraun
authors.forename: Arezoo
authors.initials: A
authors.lastname: Zomorrodi
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Pitetti
mesh_terms: D000402:Airway Obstruction / Q000453:epidemiology; D001049:Apnea / Q000453:epidemiology; D016470:Bacteremia / Q000453:epidemiology; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology*; D001437:Bacteriuria / Q000453:epidemiology; D002555:Cerebrospinal Fluid / Q000382:microbiology; D015897:Comorbidity; D003955:Diagnostic Tests, Routine; D004630:Emergencies / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005483:Flushing / Q000453:epidemiology; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D008297:Male; D009123:Muscle Hypotonia / Q000453:epidemiology; D010167:Pallor / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology