{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T12:24:12Z","timestamp":1794313452613,"version":"4.9.0"},"reference-count":14,"publisher":"American Academy of Pediatrics (AAP)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                  <jats:p>The AAP\u2019s Clinical Practice Guidelines (CPG) for febrile infants provides recommendations in evaluating well-appearing febrile infants aged 8\u201360 days at risk for invasive bacterial infections (IBIs; ie, bacteremia and bacterial meningitis). However, guidance remains limited for the infants excluded from (ie, ineligible for) the CPG. The objectives are to estimate the proportion of well-appearing CPG-ineligible febrile infants and to examine CPG performance in detecting IBIs for CPG-ineligible febrile infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We performed a secondary analysis of single-site data collected for a prior study from 2011 to 2018. Infants were included if they were 8\u201360 days and well-appearing. We stratified IBI risk using age and CPG inflammatory marker thresholds for temperature, absolute neutrophil count, and C-reactive protein. We conducted analyses on CPG-ineligible infants and CPG-eligible infants. We estimated the areas under the receiver operating characteristics curve, sensitivity, and specificity of both approaches in detecting IBIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of 648 infants, 22% did not meet CPG eligibility. Sensitivities for both analyses were 100% with specificities for CPG-ineligible and eligible of 38.1% (95% CI, 30\u201347) and 38.2% (95% CI, 33.9\u201342.6), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Strict adherence to the CPG may result in a substantial proportion of ineligible infants. Findings suggest that CPG-based approaches can maintain high sensitivities for all febrile infants, including CPG-ineligible infants. Future studies should examine the contribution of specific conditions (eg, preterm birth) to IBI risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2023-007458","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T08:06:52Z","timestamp":1732262812000},"page":"e509-e512","source":"Crossref","is-referenced-by-count":3,"title":["Performance of AAP CPG for Ineligible Well-Appearing Febrile Infants Aged 8\u201360 Days"],"prefix":"10.1542","volume":"14","author":[{"given":"Melissa J.","family":"Knudson","sequence":"first","affiliation":[{"name":"aDepartment of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Yaeger","sequence":"additional","affiliation":[{"name":"aDepartment of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York"},{"name":"bDepartment of Public Health Sciences, University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"issue":"3","key":"2024120102512702500_B1","doi-asserted-by":"crossref","first-page":"e190874","DOI":"10.1001\/jamanetworkopen.2019.0874","article-title":"Prevalence of bacteremia and bacterial meningitis in febrile neonates and infants in the second month of life: a systematic review and meta-analysis","volume":"2","author":"Biondi","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"4","key":"2024120102512702500_B2","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1001\/jamapediatrics.2018.5501","article-title":"A clinical prediction rule to identify febrile infants 60 days and younger at low risk for serious bacterial infections","volume":"173","author":"Kuppermann","year":"2019","journal-title":"JAMA 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