{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:14:47Z","timestamp":1753892087959,"version":"3.41.2"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>To determine the rate of serious-bacterial-infections (SBI) in young ex-premature infants with fever, and to develop a risk-stratification algorithm for these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study including all infants who presented to the pediatric emergency department (ED) of a tertiary-care university-hospital between 2010 and 2020 with fever (\u226538\u00b0C), were born prematurely (&amp;lt;37-weeks), had post-conception age of &amp;lt;52-weeks, and had available blood, urine, or CSF cultures. The rates of SBI by age-of-birth and age-at-visit were calculated and compared to a cohort of matched full-term controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included a total of 290 ex-premature cases and 290 full-term controls. There were 11 cases (3.8%) with an invasive bacterial infection (IBI) of either bacteremia, meningitis or both and only six controls (2.1%) with IBI (<jats:italic>p<\/jats:italic>\u2009=\u20090.32). Over 28-days chronologic-age, there were 10 (3.6%) IBIs among cases and no IBIs among the controls (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). There were eight (3%) cases and three (1%) controls with IBI who were well-appearing on physical examination (<jats:italic>p<\/jats:italic>\u2009=\u20090.19). All eight well-appearing ex-premature infants were under 60-days adjusted-age, seven of whom (88%) were also under 28-days adjusted-age. There were 28 (10.6%) cases and 34 (12%) controls with urinary tract infection (UTI) (<jats:italic>p<\/jats:italic>\u2009=\u20090.5). Among cases under 60-days adjusted-age, urinalysis was not reliable to exclude UTI (50% negative).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Well-appearing ex-preterm infants have a significant risk for IBI until the adjusted age of 28-days and for UTI until the adjusted age of 60-days. Further studies are needed to evaluate the approach to fever in this unique population.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.1021007","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T06:42:56Z","timestamp":1665556976000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The risk of serious bacterial infections among young ex-premature infants with fever"],"prefix":"10.3389","volume":"10","author":[{"given":"Yuval","family":"Barak-Corren","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoav","family":"Elizur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shira","family":"Yuval","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amalia","family":"Burstyn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noy","family":"Deri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shepard","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orli","family":"Megged","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ori","family":"Toker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications","volume":"379","author":"Blencowe","year":"2012","journal-title":"The Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1001\/jama.2015.10244","article-title":"Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012","volume":"314","author":"Stoll","year":"2015","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1542\/peds.85.6.1040","article-title":"Failure of infant observation scales in detecting serious illness in febrile, 4- to 8-week-old infants","volume":"85","author":"Baker","year":"1990","journal-title":"Pediatrics"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1016\/S0196-0644(05)80991-6","article-title":"Practice guideline for the management of infants and children 0 to 36 months of age with fever without source. 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