{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:45:35Z","timestamp":1791780335109,"version":"4.3.4"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","funder":[{"name":"Sociedad Espa\u00c3\u00b1ola de Urgencias Pedi\u00c3\u00a1tricas"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n \n Invasive bacterial infections (IBIs) in febrile infants \u226490 days are mostly caused by\n Escherichia coli<\/jats:italic>\n and\n Streptococcus agalactiae<\/jats:italic>\n . However, data on IBIs caused by other pathogens remain limited.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n We conducted a multicenter retrospective study of febrile infants aged \u226490 days diagnosed with IBI between 2008 and 2022 at 12 Spanish pediatric emergency departments. Epidemiology, clinical features, microbiology and outcomes of cases caused by pathogens other than\n E. coli<\/jats:italic>\n \/\n S. agalactiae<\/jats:italic>\n were analyzed. Adverse outcomes included death, inotropic or respiratory support, acute complications, or sequelae.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 375 infants with IBI, 106 (28.3%) had infections caused by pathogens other than\n E. coli<\/jats:italic>\n \/\n S. agalactiae<\/jats:italic>\n . The most frequent pathogens were\n Staphylococcus aureus<\/jats:italic>\n (n = 30, 8.0%),\n Streptococcus pneumoniae<\/jats:italic>\n (n = 15, 4.0%) and\n Enterococcus faecalis<\/jats:italic>\n (n = 14, 3.7%). Most cases presented as isolated bacteremia (65.1%), followed by bacteremic urinary tract infection (18.9%) and meningitis (12.3%); 46.2% of infants with meningitis had a concomitant urinary tract infection. The distribution of pathogens varied according to age, with\n S. aureus<\/jats:italic>\n being more frequent among younger infants and\n S. pneumoniae<\/jats:italic>\n accounting for 8.6% of IBIs in infants aged 61\u201390 days.\n Listeria monocytogenes<\/jats:italic>\n caused 1.3% of IBIs, with only 1 case identified in the last decade. Adverse outcomes occurred in 7.5% of infants with infections caused by other pathogens and 8.6% of those with\n E. coli<\/jats:italic>\n \/\n S. agalactiae<\/jats:italic>\n (absolute risk difference, \u22121.0% [95% confidence interval, \u22127.1 to 5.0]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n IBIs caused by pathogens other than\n E. coli<\/jats:italic>\n \/\n S. agalactiae<\/jats:italic>\n accounted for a substantial proportion of cases and showed an age-dependent distribution. Most presented as isolated bacteremia, while meningitis was associated with a higher observed frequency of adverse outcomes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/inf.0000000000005437","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:00:42Z","timestamp":1791777642000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Invasive Bacterial Infections Other Than Escherichia coli and Streptococcus agalactiae in Febrile Infants Younger Than 90 Days"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8344-8427","authenticated-orcid":false,"given":"Mar\u00eda","family":"Su\u00e1rez-Bustamante Hu\u00e9lamo","sequence":"first","affiliation":[{"name":"Emergency Department, Hospital Infantil Universitario Ni\u00f1o Jes\u00fas, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7648-1336","authenticated-orcid":false,"given":"Jose Antonio","family":"Alonso-Cadenas","sequence":"additional","affiliation":[{"name":"Emergency Department, Hospital Infantil Universitario Ni\u00f1o Jes\u00fas, Madrid, Spain"},{"name":"Fundaci\u00f3n para la Investigaci\u00f3n Biom\u00e9dica, Hospital Infantil Universitario Ni\u00f1o Jes\u00fas, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-4494","authenticated-orcid":false,"given":"Borja","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department, Cruces University Hospital, Barakaldo, Spain"},{"name":"Biocruces Bizkaia Health Research Institute, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Sorolla-Angl\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Parc Taul\u00ed Hospital Universitari, Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed (I3PT-CERCA), Sabadell, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6443-2481","authenticated-orcid":false,"given":"Susanna","family":"Hern\u00e1ndez-Bou","sequence":"additional","affiliation":[{"name":"Emergency Department, Hospital Sant Joan de D\u00e9u Barcelona, Esplugues de Llobregat, Spain"},{"name":"Child and Adolescent Well-Being and Environmental Influences, Institut de Recerca Sant Joan de D\u00e9u (IRSJD), Esplugues de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Borrull-Senra","sequence":"additional","affiliation":[{"name":"Emergency Department, Hospital Sant Joan de D\u00e9u Barcelona, Esplugues de Llobregat, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9805-0097","authenticated-orcid":false,"given":"Amaia","family":"C\u00e1mara","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department, Donostia Ospitalea, Donostia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5664-2593","authenticated-orcid":false,"given":"Roc\u00edo","family":"Rodrigo","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, Hospital Vall d\u2019Hebron, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Gastroenterology and Pediatric Nutrition Section, Hospital Complex of Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7036-7308","authenticated-orcid":false,"given":"Cristina","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Unit, Department of Pediatrics, Hospital Universitario Marqu\u00e9s de Valdecilla, Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6208-5601","authenticated-orcid":false,"given":"Julio","family":"Baena-Baca","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital de Matar\u00f3, Consorci Sanitari del Maresme, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9761-1040","authenticated-orcid":false,"given":"Luc\u00eda","family":"Garriga","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Bonill","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Consorci Sanitari de Terrassa, Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8974-2735","authenticated-orcid":false,"given":"Maria Concepci\u00f3n","family":"Villal\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital Universitario de Salamanca, Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laia","family":"S\u00e1nchez-Torrent","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital General de Sant Boi, Sant Boi, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0073-2650","authenticated-orcid":false,"given":"Roberto","family":"Velasco","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Parc Taul\u00ed Hospital Universitari, Institut d\u2019Investigaci\u00f3 i Innovaci\u00f3 Parc Taul\u00ed (I3PT-CERCA), Sabadell, Spain"},{"name":"Pediatrics & Child Health, University College Cork, Cork, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"R1-20261012","doi-asserted-by":"crossref","first-page":"e278","DOI":"10.1097\/INF.0000000000003947","article-title":"Febrile urinary tract infection in infants less than 3 months of age.","volume":"42","author":"Lejarzegi","year":"2023","journal-title":"Pediatr Infect Dis J"},{"key":"R2-20261012","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.jpeds.2018.04.033","article-title":"Epidemiology and etiology of invasive bacterial infection in infants \u226460 days old treated in emergency departments.","volume":"200","author":"Woll","year":"2018","journal-title":"J Pediatr"},{"key":"R3-20261012","first-page":"1163","article-title":"Prevalence of bacterial infection in febrile infants 61\u201390 days old compared with younger infants.","volume":"39","author":"Bonilla","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"R4-20261012","doi-asserted-by":"crossref","first-page":"e2024066588F","DOI":"10.1542\/peds.2024-066588F","article-title":"Efficacy of antibiotic regimens for sepsis or possible serious bacterial infection in young infants aged 0 to 59 days: a systematic review and meta-analysis.","volume":"154","author":"North","year":"2024","journal-title":"Pediatrics"},{"key":"R5-20261012","doi-asserted-by":"crossref","first-page":"114578","DOI":"10.1016\/j.jpeds.2025.114578","article-title":"A population-based study of rates of invasive bacterial infection (IBI) and missed IBI in febrile infants 8\u201390 days of age.","volume":"282","author":"Yaeger","year":"2025","journal-title":"J Pediatr"},{"key":"R6-20261012","doi-asserted-by":"crossref","first-page":"e20160270","DOI":"10.1542\/peds.2016-0270","article-title":"Management and outcomes of previously healthy, full-term, febrile infants ages 7 to 90 days.","volume":"138","author":"Greenhow","year":"2016","journal-title":"Pediatrics"},{"key":"R7-20261012","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.annemergmed.2017.07.488","article-title":"Epidemiology of bacteremia in febrile infants aged 60 days and younger.","volume":"71","author":"Powell","year":"2018","journal-title":"Ann Emerg Med"},{"key":"R8-20261012","doi-asserted-by":"crossref","first-page":"e2021052228","DOI":"10.1542\/peds.2021-052228","article-title":"Evaluation and management of well-appearing febrile infants 8 to 60 days old.","volume":"148","author":"Pantell","year":"2021","journal-title":"Pediatrics"},{"key":"R9-20261012","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1097\/INF.0000000000003714","article-title":"Changes in etiology of invasive bacterial infections in infants under 3 months of age in Korea, 2006\u20132020.","volume":"41","author":"Song","year":"2022","journal-title":"Pediatr Infect Dis J"},{"key":"R10-20261012","doi-asserted-by":"crossref","first-page":"e161","DOI":"10.1097\/INF.0000000000002241","article-title":"Epidemiology of serious bacterial infections in infants less than 90 days of age, presenting to a tertiary care emergency department, 2010 to 2016.","volume":"38","author":"Mah","year":"2019","journal-title":"Pediatr Infect Dis J"},{"key":"R11-20261012","doi-asserted-by":"crossref","first-page":"e150","DOI":"10.1093\/cid\/ciu514","article-title":"Incidence, etiology, and outcome of bacterial meningitis in infants aged <90 days in the United Kingdom and Republic of Ireland: prospective, enhanced, national population-based surveillance.","volume":"59","author":"Okike","year":"2014","journal-title":"Clin Infect Dis"},{"key":"R12-20261012","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1097\/INF.0000000000004053","article-title":"Staphylococcus aureus bacteremia in the pediatric emergency department and predictors of poor outcome.","volume":"42","author":"Su\u00e1rez-Bustamante Hu\u00e9lamo","year":"2023","journal-title":"Pediatr Infect Dis J"},{"key":"R13-20261012","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1097\/INF.0000000000001225","article-title":"Comparison of febrile infants with enterococcal and Gram-negative urinary tract infections.","volume":"35","author":"Lubell","year":"2016","journal-title":"Pediatr Infect Dis J"},{"key":"R14-20261012","doi-asserted-by":"crossref","first-page":"2516699","DOI":"10.1080\/19490976.2025.2516699","article-title":"Comprehensive analysis of Enterococcus spp. from two European healthy infant cohorts shows stable genomic traits including antimicrobial resistance (AMR).","volume":"17","author":"Saeed","year":"2025","journal-title":"Gut Microbes"},{"key":"R15-20261012","doi-asserted-by":"crossref","first-page":"8926","DOI":"10.1038\/s41598-019-45441-3","article-title":"Intestinal translocation of enterococci requires a threshold level of enterococcal overgrowth in the lumen.","volume":"9","author":"Archambaud","year":"2019","journal-title":"Sci Rep"},{"key":"R16-20261012","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.ajem.2016.12.017","article-title":"Procalcitonin levels in bloodstream infections caused by different sources and species of bacteria.","volume":"35","author":"Yan","year":"2017","journal-title":"Am J Emerg Med"},{"key":"R17-20261012","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1136\/archdischild-2021-321602","article-title":"Listeria infection in young infants: results from a national surveillance study in the UK and Ireland.","volume":"106","author":"Vergnano","year":"2021","journal-title":"Arch Dis Child"},{"key":"R18-20261012","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1001\/jamapediatrics.2016.0596","article-title":"Evaluation and management of febrile children: a review.","volume":"170","author":"Cioffredi","year":"2016","journal-title":"JAMA Pediatr"},{"key":"R19-20261012","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1097\/INF.0000000000001917","article-title":"Clinical characteristics and risk factors for poor outcome in infants less than 90 days of age with bacterial meningitis in the United Kingdom and Ireland.","volume":"37","author":"Okike","year":"2018","journal-title":"Pediatr Infect Dis J"},{"key":"R20-20261012","doi-asserted-by":"crossref","first-page":"e20170476","DOI":"10.1542\/peds.2017-0476","article-title":"The epidemiology, management, and outcomes of bacterial meningitis in infants.","volume":"140","author":"Ouchenir","year":"2017","journal-title":"Pediatrics"},{"key":"R21-20261012","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.jpeds.2018.08.066","article-title":"Factors associated with adverse outcomes among febrile young infants with invasive bacterial infections.","volume":"204","author":"Pruitt","year":"2019","journal-title":"J Pediatr"}],"container-title":["Pediatric Infectious Disease Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/INF.0000000000005437","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:00:45Z","timestamp":1791777645000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/INF.0000000000005437"}},"subtitle":["A Multicenter Emergency Department Study"],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":21,"URL":"https:\/\/doi.org\/10.1097\/inf.0000000000005437","relation":{},"ISSN":["0891-3668","1532-0987"],"issn-type":[{"value":"0891-3668","type":"print"},{"value":"1532-0987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]}}}