Most Read Articles
15 Sep 2016
Tigecycline therapy produces favourable outcomes in severe Clostridium difficile infection (sCDI), says a study.
Roshini Claire Anthony, 22 May 2018

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

Pearl Toh, 28 Dec 2017
The addition of low oxygen levels measured by pulse oximetry to the three signs delineated in the current diagnostic model for pneumonia in primary care setting derived by van Vugt, which include fever, tachycardia, and crackly breath sounds on auscultation, can add value to diagnostic precision and help general practitioners (GPs) differentiate pneumonia from less serious infections, a study suggests.
26 Sep 2017
Ceftazidime-avibactam appears to offer a reasonable alternative to colistin in the treatment of Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Enterobacteriaceae (CRE) infections, according to a study.

Guidelines lack capacity to predict serious infections in febrile infants

10 Jan 2018
Newborn infant baby boy receiving phototherapy for jaundice at the hospital.

For febrile infants younger than 3 months old, current heart rate guidelines have variable performances, a recent Singapore study has found. Particularly, while the Advanced Paediatric Life Support (APLS) guideline had the greatest sensitivity, no individual guideline could satisfactorily predict serious infections (SIs).

A retrospective review of 1,057 infants (mean age 1.1±1.0 months), recruited from the KK Women’s and Children’s Hospital in Singapore, showed that the rate of SIs was 30.8 percent (n=326). A larger proportion of infants with SIs were administered ampicillin and gentamicin after admission (p<0.001 for both).

Univariate analysis identified temperature (p<0.001), heart rate (p=0.006), triage category (p=0.019), and Severity Index Score (SIS) category (p=0.005), total white blood cell count (p<0.001), absolute neutrophil count (p<0.001), platelet count (p=0.001) and C-reactive protein concentrations (p<0.001) as significantly predictive of SIs.

The most common SI was urinary tract infection, observed in 178 infants. The most common pathogens associated with this infection were Escherichia coli, Klebsiella pneumoniae and Enterococcus faecalis. Meningitis (n=112), septicaemia (n=21), and lobar pneumonia (n=7) were also commonly observed, with E. coli as a common cause.

Aside from the APLS, the Fleming normal reference values also resulted in a high sensitivity for abnormal heart rate (66.0 and 62.6 percent, respectively). Both also had the highest negative predictive values (73.3 and 71.4 percent, respectively).

In contrast, the Paediatric Canadian Triage and Acuity Scale yielded corresponding values of 23.0 and 69.5 percent. None of the guidelines examined reached a sensitivity of >70 percent.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
15 Sep 2016
Tigecycline therapy produces favourable outcomes in severe Clostridium difficile infection (sCDI), says a study.
Roshini Claire Anthony, 22 May 2018

The combined use of piperacillin and tazobactam does not appear to be a suitable alternative to meropenem for patients with bloodstream infections caused by ceftriaxone-resistant Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae), according to results of the MERINO* trial.

Pearl Toh, 28 Dec 2017
The addition of low oxygen levels measured by pulse oximetry to the three signs delineated in the current diagnostic model for pneumonia in primary care setting derived by van Vugt, which include fever, tachycardia, and crackly breath sounds on auscultation, can add value to diagnostic precision and help general practitioners (GPs) differentiate pneumonia from less serious infections, a study suggests.
26 Sep 2017
Ceftazidime-avibactam appears to offer a reasonable alternative to colistin in the treatment of Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Enterobacteriaceae (CRE) infections, according to a study.