{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T12:25:17Z","timestamp":1794313517689,"version":"4.9.0"},"reference-count":14,"publisher":"California Digital Library (CDL)","issue":"5","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["WestJEM"],"abstract":"<jats:p>Introduction: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the coronavirus disease 2019 (COVID-19) pandemic that drastically impacted the United States. The evidence was not clear on how SARS-CoV-2 infection impacted children, given the high prevalence of SAR-CoV-2 infection. Febrile infants less than 60 days old are an ongoing challenge to risk-stratify for serious bacterial infection (SBI), including urinary tract infection (UTI), bacteremia, and meningitis. We hypothesized there would be a lower rate of SBI in SARS-CoV-2 positive febrile infants compared to those SARS-CoV-2 negative. \n\nMethods: This was a retrospective chart review with a nested, age-matched, case-control study performed from March 2020\u2013June 2021. Infants less than 60 days old presenting with fever were assigned groups based on SARS-CoV-2 infection. Blood, urine, and cerebrospinal fluid cultures were used as the gold standard to diagnose SBI. We compared overall rate of SBI as well as individual rates of SBI between each group. We performed a subgroup analysis evaluating the age group 29-60 days old. \n\nResults: A total of 164 subjects met criteria for analysis: 30 COVID-19 positive and 134 COVID-19 negative subjects. Rate of SBI was 17.9% (95% confidence interval [CI]: 11.8-25.5%) in the COVID-19 negative group compared to 0% (95% CI: 0.0%-11.1%) in the COVID-19 group, which demonstrated statistical significance (p = 0.008). In the age-matched data, we found statistical significance for any SBI (p = &lt;0.001). For individual rates of SBI, we found statistical significance for UTI (p = &lt;0.001) and bacteremia (p = &lt;0.001). The 29- 60 days-old subgroup analysis did not achieve statistical significance (p = 0.11).\n\nConclusion: This study demonstrated the utility of including SARS-CoV-2 infection as part of the risk stratification of febrile infants less than 60 days old. While overall there is a low incidence of bacteremia and meningitis in this age group, these results can contribute to existing literature and potentially help decrease invasive testing and exposure to broad-spectrum antibiotics.<\/jats:p>","DOI":"10.5811\/westjem.2022.6.54863","type":"journal-article","created":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T22:45:10Z","timestamp":1664145910000},"page":"754-759","source":"Crossref","is-referenced-by-count":14,"title":["COVID-19 and Serious Bacterial Infection in Febrile Infants Less Than 60 Days Old"],"prefix":"10.5811","volume":"23","author":[{"given":"David","family":"Guernsey","sequence":"first","affiliation":[{"name":"Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Pfeffer","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kimpo","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Vazquez","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Zerzan","sequence":"additional","affiliation":[{"name":"Maimonides Medical Center, Department of Emergency Medicine, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29705","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"ref0","unstructured":"CDC. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. 2020. Available at: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/index.html. Accessed April 5, 2021."},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Kanburoglu MK, Tayman C, Oncel MY, et al. A multicentered study on epidemiologic and clinical characteristics of 37 neonates with community-acquired COVID-19. Pediatr Infect Dis J. 2020;39(10):e297-302.","DOI":"10.1097\/inf.0000000000002862"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Zeng L, Xia S, Yuan W, et al. Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr. 2020;174(7):722-5.","DOI":"10.1001\/jamapediatrics.2020.0878"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Mithal LB, Machut KZ, Muller WJ, et al. SARS-CoV-2 Infection in infants less than 90 days old. J Pediatr. 2020;224:150-2.","DOI":"10.1016\/j.jpeds.2020.06.047"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Biondi E, Evans R, Mischler M, et al. Epidemiology of bacteremia in febrile infants in the United States. Pediatrics. 2013;132(6):990-6.","DOI":"10.1542\/peds.2013-4017"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Aronson PL, Thurm C, Alpern ER, et al. Variation in care of the febrile young infant <90 days in US pediatric emergency departments. Pediatrics. 2014;134(4):667-77.","DOI":"10.1542\/peds.2014-3232"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Kuppermann N, Dayan PS, Levine DA, et al. A clinical prediction rule to identify febrile infants 60 days and younger at low risk for serious bacterial infections. JAMA Pediatr. 2019;173(4):342-51.","DOI":"10.1001\/jamapediatrics.2019.2656"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Pantell RH, Roberts KB, Adams WG, et al. Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics. 2021;148(2).","DOI":"10.1542\/peds.2021-054063"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Bachur RG, Harper MB. Predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics. 2001;108(2):311-6.","DOI":"10.1542\/peds.108.2.311"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Byington CL, Enriquez FR, Hoff C, et al. Serious bacterial infections in febrile infants 1 to 90 days old with and without viral infections. Pediatrics. 2004;113(6):1662-6.","DOI":"10.1542\/peds.113.6.1662"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Levine DA, Platt SL, Dayan PS, et al. Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections. Pediatrics. 2004;113(6):1728-34.","DOI":"10.1542\/peds.113.6.1728"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Payson A, Etinger V, Napky P, et al. Risk of serious bacterial infections in young febrile infants with COVID-19. Pediatr Emerg Care. 2021;37(4):232-6.","DOI":"10.1097\/pec.0000000000002380"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"New York State Department of Health. School Immunization Survey: Beginning 2012-13 School Year. Albany, NY: NYS Department of Health. 2021. Available at: https:\/\/health.data.ny.gov\/Health\/School-Immunization-Survey-Beginning-2012-13-Schoo\/5pme-xbs5. Accessed June 4, 2022.","DOI":"10.47988\/janany.23587684.2.1"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Weems MF, Wei D, Ramanathan R, et al. Urinary tract infections in a neonatal intensive care unit. Am J Perinatol. 2015;32(7):695-702.","DOI":"10.1055\/s-0034-1395474"}],"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T22:45:15Z","timestamp":1664145915000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/46d5q6rw"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,10]]},"references-count":14,"issue-title":["Western Journal Of Emergency Medicine"],"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,9,20]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.2022.6.54863","relation":{},"ISSN":["1936-900X"],"issn-type":[{"value":"1936-900X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,8,10]]}}}