Serious bacterial infections in infants who have experienced an apparent life-threatening event.
OBJECTIVE
We determine the incidence of serious bacterial infection in infants presenting to the emergency department (ED) with an apparent life-threatening event.


METHODS
This was a prospective cohort study of infants younger than 12 months who were treated at an urban children's hospital ED during 1 year and who met standard criteria for an apparent life-threatening event. Sociodemographic data, presenting features, diagnostic testing, hospital course, and final diagnosis were collected. Follow-up information was obtained 4 weeks after the visit.


RESULTS
Of the 198 infants enrolled, 44 (22.2%) had evaluation for serious bacterial infection: urine culture 36 (18%), blood culture 38 (19%) and cerebrospinal fluid culture 18 (9%). No infant (0/198; 95% confidence interval 0% to 1.8%) was found to have bacteremia, urinary tract infection, or bacterial meningitis, which was confirmed at the 4-week interview (99% ascertainment). Two infants were found to have enteroviral meningitis.


CONCLUSIONS
The incidence of serious bacterial infection in this cohort was extremely low. Infants presenting with an apparent life-threatening event need not be subjected to a full serious bacterial infection evaluation routinely.
Mittal
Manoj K
MK
Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399, USA. mittal@email.chop.edu
Shofer
Frances S
FS
Baren
Jill M
JM
D001049:Apnea / Q000453:epidemiology; D001424:Bacterial Infections / Q000453:epidemiology*; D001988:Bronchiolitis / Q000453:epidemiology; D016638:Critical Illness / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008587:Meningitis, Viral / Q000453:epidemiology; D015143:Philadelphia / Q000453:epidemiology; D011446:Prospective Studies