Risks for bacteremia and urinary tract infections in young febrile children with bronchiolitis

Nathan Kuppermann, David E. Bank, Edward A. Walton, Melvin O. Senac, Jan McCaslin

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Objective: To compare the risks for bacteremia and urinary tract infections (UTI) in young febrile children with and without bronchiolitis. Design: A prospective cohort study. Setting: The emergency departments of 3 pediatric referral hospitals. Patients: A convenience sample of 432 previously healthy febrile patients aged 24 months or younger. Patients were divided into groups, based on the presence (n= 163, bronchiolitis group) or absence (n=269, control group) of wheezing and/or retractions on examination. Blood cultures were obtained from all patients, and urine cultures were obtained from female patients, and male patients aged 6 months or younger. Chest radiographs were obtained on patients with lower respiratory tract signs, and those with lobar pneumonias were excluded (7 wheezing and 8 non- wheezing patients), leaving 156 patients with bronchiolitis and 261 control patients. Outcome Measures: Growth of any bacterial pathogens from the blood or 10 4 colony-forming units per milliliter or more from the urine. Results: None of the 156 patients with bronchiolitis had bacteremia (95% confidence interval, 0%-1.9%) vs 2.7% of the 261 controls (95% confidence interval, 1.1%-5.4%; P=.049); 1.9% of the patients with bronchiolitis had UTI vs 13.6% of the controls (odds ratio, 0.12; 95% confidence interval, 0.02-0.55; P=.001). None of the subset of patients with bronchiolitis aged 2 months or younger (n=36) had bacteremia or UTI; however, there were not enough of these younger patients to make statistically conclusive comparisons. Conclusion: Previously healthy febrile children aged 24 months or younger with bronchiolitis are unlikely to have bacteremia or UTI. Therefore, routine cultures of the blood and urine in these patients are unnecessary. More data are needed regarding the subset of febrile infants aged 2 months or younger with bronchiolitis.

Original languageEnglish (US)
Pages (from-to)1207-1214
Number of pages8
JournalArchives of Pediatrics and Adolescent Medicine
Volume151
Issue number12
StatePublished - 1997

Fingerprint

Bronchiolitis
Bacteremia
Urinary Tract Infections
Fever
Respiratory Sounds
Urine
Confidence Intervals
Pediatric Hospitals
Respiratory System

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Risks for bacteremia and urinary tract infections in young febrile children with bronchiolitis. / Kuppermann, Nathan; Bank, David E.; Walton, Edward A.; Senac, Melvin O.; McCaslin, Jan.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 151, No. 12, 1997, p. 1207-1214.

Research output: Contribution to journalArticle

Kuppermann, Nathan ; Bank, David E. ; Walton, Edward A. ; Senac, Melvin O. ; McCaslin, Jan. / Risks for bacteremia and urinary tract infections in young febrile children with bronchiolitis. In: Archives of Pediatrics and Adolescent Medicine. 1997 ; Vol. 151, No. 12. pp. 1207-1214.
@article{a353b8695c57401f8fbc4a809cf9a738,
title = "Risks for bacteremia and urinary tract infections in young febrile children with bronchiolitis",
abstract = "Objective: To compare the risks for bacteremia and urinary tract infections (UTI) in young febrile children with and without bronchiolitis. Design: A prospective cohort study. Setting: The emergency departments of 3 pediatric referral hospitals. Patients: A convenience sample of 432 previously healthy febrile patients aged 24 months or younger. Patients were divided into groups, based on the presence (n= 163, bronchiolitis group) or absence (n=269, control group) of wheezing and/or retractions on examination. Blood cultures were obtained from all patients, and urine cultures were obtained from female patients, and male patients aged 6 months or younger. Chest radiographs were obtained on patients with lower respiratory tract signs, and those with lobar pneumonias were excluded (7 wheezing and 8 non- wheezing patients), leaving 156 patients with bronchiolitis and 261 control patients. Outcome Measures: Growth of any bacterial pathogens from the blood or 10 4 colony-forming units per milliliter or more from the urine. Results: None of the 156 patients with bronchiolitis had bacteremia (95{\%} confidence interval, 0{\%}-1.9{\%}) vs 2.7{\%} of the 261 controls (95{\%} confidence interval, 1.1{\%}-5.4{\%}; P=.049); 1.9{\%} of the patients with bronchiolitis had UTI vs 13.6{\%} of the controls (odds ratio, 0.12; 95{\%} confidence interval, 0.02-0.55; P=.001). None of the subset of patients with bronchiolitis aged 2 months or younger (n=36) had bacteremia or UTI; however, there were not enough of these younger patients to make statistically conclusive comparisons. Conclusion: Previously healthy febrile children aged 24 months or younger with bronchiolitis are unlikely to have bacteremia or UTI. Therefore, routine cultures of the blood and urine in these patients are unnecessary. More data are needed regarding the subset of febrile infants aged 2 months or younger with bronchiolitis.",
author = "Nathan Kuppermann and Bank, {David E.} and Walton, {Edward A.} and Senac, {Melvin O.} and Jan McCaslin",
year = "1997",
language = "English (US)",
volume = "151",
pages = "1207--1214",
journal = "JAMA Pediatrics",
issn = "2168-6203",
publisher = "American Medical Association",
number = "12",

}

TY - JOUR

T1 - Risks for bacteremia and urinary tract infections in young febrile children with bronchiolitis

AU - Kuppermann, Nathan

AU - Bank, David E.

AU - Walton, Edward A.

AU - Senac, Melvin O.

AU - McCaslin, Jan

PY - 1997

Y1 - 1997

N2 - Objective: To compare the risks for bacteremia and urinary tract infections (UTI) in young febrile children with and without bronchiolitis. Design: A prospective cohort study. Setting: The emergency departments of 3 pediatric referral hospitals. Patients: A convenience sample of 432 previously healthy febrile patients aged 24 months or younger. Patients were divided into groups, based on the presence (n= 163, bronchiolitis group) or absence (n=269, control group) of wheezing and/or retractions on examination. Blood cultures were obtained from all patients, and urine cultures were obtained from female patients, and male patients aged 6 months or younger. Chest radiographs were obtained on patients with lower respiratory tract signs, and those with lobar pneumonias were excluded (7 wheezing and 8 non- wheezing patients), leaving 156 patients with bronchiolitis and 261 control patients. Outcome Measures: Growth of any bacterial pathogens from the blood or 10 4 colony-forming units per milliliter or more from the urine. Results: None of the 156 patients with bronchiolitis had bacteremia (95% confidence interval, 0%-1.9%) vs 2.7% of the 261 controls (95% confidence interval, 1.1%-5.4%; P=.049); 1.9% of the patients with bronchiolitis had UTI vs 13.6% of the controls (odds ratio, 0.12; 95% confidence interval, 0.02-0.55; P=.001). None of the subset of patients with bronchiolitis aged 2 months or younger (n=36) had bacteremia or UTI; however, there were not enough of these younger patients to make statistically conclusive comparisons. Conclusion: Previously healthy febrile children aged 24 months or younger with bronchiolitis are unlikely to have bacteremia or UTI. Therefore, routine cultures of the blood and urine in these patients are unnecessary. More data are needed regarding the subset of febrile infants aged 2 months or younger with bronchiolitis.

AB - Objective: To compare the risks for bacteremia and urinary tract infections (UTI) in young febrile children with and without bronchiolitis. Design: A prospective cohort study. Setting: The emergency departments of 3 pediatric referral hospitals. Patients: A convenience sample of 432 previously healthy febrile patients aged 24 months or younger. Patients were divided into groups, based on the presence (n= 163, bronchiolitis group) or absence (n=269, control group) of wheezing and/or retractions on examination. Blood cultures were obtained from all patients, and urine cultures were obtained from female patients, and male patients aged 6 months or younger. Chest radiographs were obtained on patients with lower respiratory tract signs, and those with lobar pneumonias were excluded (7 wheezing and 8 non- wheezing patients), leaving 156 patients with bronchiolitis and 261 control patients. Outcome Measures: Growth of any bacterial pathogens from the blood or 10 4 colony-forming units per milliliter or more from the urine. Results: None of the 156 patients with bronchiolitis had bacteremia (95% confidence interval, 0%-1.9%) vs 2.7% of the 261 controls (95% confidence interval, 1.1%-5.4%; P=.049); 1.9% of the patients with bronchiolitis had UTI vs 13.6% of the controls (odds ratio, 0.12; 95% confidence interval, 0.02-0.55; P=.001). None of the subset of patients with bronchiolitis aged 2 months or younger (n=36) had bacteremia or UTI; however, there were not enough of these younger patients to make statistically conclusive comparisons. Conclusion: Previously healthy febrile children aged 24 months or younger with bronchiolitis are unlikely to have bacteremia or UTI. Therefore, routine cultures of the blood and urine in these patients are unnecessary. More data are needed regarding the subset of febrile infants aged 2 months or younger with bronchiolitis.

UR - http://www.scopus.com/inward/record.url?scp=0030700228&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030700228&partnerID=8YFLogxK

M3 - Article

C2 - 9412595

AN - SCOPUS:0030700228

VL - 151

SP - 1207

EP - 1214

JO - JAMA Pediatrics

JF - JAMA Pediatrics

SN - 2168-6203

IS - 12

ER -