Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger

How accurately does a clinical prediction rule based on urinalysis, procalcitonin, and absolute neutrophil count identify febrile young infants at low risk for bacteremia and/or bacterial meningitis?Among 1537 febrile infants 28 days or younger from 4 studies in 6 countries, the prediction rule had a sensitivity of 94.2%, specificity of 41.6%, positive predictive value of 6.9%, and negative predictive value of 99.4% for bacteremia and bacterial meningitis; no infants classified as being at low risk had bacterial meningitis.A prediction rule using laboratory tests without lumbar puncture had high sensitivity but more limited specificity for identifying febrile infants 28 days or younger with invasive bacterial infections.

Corresponding Author: Brett Burstein, MDCM, PhD, MPH, Montreal Children’s Hospital, McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada (brett.burstein@mail.mcgill.ca).

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