The Comparison of the Management Models for Identifying the Risk of Serious Bacterial Infection in Newborn Infants with a Newly Developed Scale
Journal Title: Journal of Academic Research in Medicine - Year 2020, Vol 10, Issue 1
Abstract
Objective: We aimed to evaluate the major approach protocols of fever in febrile newborn and to define the incidence of serious bacterial infections (SBI) in febrile newborns. Methods: This study was designed as a prospective observational cohort study and directed between January 2011 and December 2015. All newborns with a rectal temperature of ≥38 °C and admitted to the neonatal intensive care unit were eligible for participation in the study. Infants were evaluated and classified as low-risk using the Boston criteria, the Philadelphia criteria, and the Rochester criteria, and our newly developed İstanbul criteria. The protocol results were compared regarding calculations of sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and likelihood ratio (LR). Results: During the study period, 328 infants were enrolled and the frequency of SBI was found as 38.4%. The leading etiology was fever of unknown origin with 43.6%, followed by urinary tract infection, dehydration, and bacteremia, accounting for 15.5%, 14%, and 5.8%, respectively. The highest sensitivity and NPV and the lowest negative LR were noted with the İstanbul protocol. The highest PPV was found in the Philadelphia and Boston protocols. Conclusion: The low-risk criteria of febrile infant protocols are not sufficiently reliable to exclude the presence of SBI in febrile neonates. The low-risk criteria in our new protocol were detected to be more reliable and may be useful in excluding SBI in the neonatal period.
Authors and Affiliations
Ali Bülbül, Lida Bülbül, Umut Zübarioğlu, Seda Ocak, Sinan Uslu
Keywords
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- DOI 10.4274/jarem.galenos.2019.2577
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