%0 Journal Article
%T Validaci¨®n de criterios para bajo riesgo de infecci¨®n bacteriana grave en reci¨¦n nacidos febriles
%A D¨ªaz ¨¢lvarez
%A Manuel
%A Benitz
%A William E.
%A Mart¨ªnez Canalejo
%A Humberto
%A Moreno V¨¢zquez
%A Olimpo
%J Revista Cubana de Pediatr£¿-a
%D 2007
%I Editorial Ciencias M¨¦dicas
%X criteria for prediction of low risk for serious bacterial infection (sbi) in febrile infants are imperfect, particularly in infants younger than 1 month. we sought to validate new criteria for evaluation of febrile neonates. to this end, 288 febrile newborns with complete evaluation for sepsis were prospectively classified as low-risk for infection if they looked well; had been previously healthy; had no signs of focal infection; did not have persistent, recurrent, or high fever 39.0c); and leukocyte counts of 520 x 109/liter, erythrocyte sedimentation rate <20 mm/hr; and <10,000 leukocytes/ml of urine. these criteria were compared to rochester criteria and false-positive and false-negative rates were compared by z-tests. sbi was present in 68 (23.6%) and bacteremia in 22 infants (7.6%). only 5 of 68 (one with bacteremia) of these infants were classified as low risk using the new criteria (false-negative rate=7.3%, 95% ci (4.711.7%) whereas 15 of 68 (3 with bacteremia) were classified as low risk using the rochester criteria (false-negative rate=22.0%, 95% ci (17.527.4%); p=0.03 vs. new criteria). the lowest false-negative rate was offset by a higher false-positive rate (65.9% vs. 37.7%). the new criteria identifying low risk for serious bacterial infection in febrile neonates had a significantly lower false-negative rate than that of the classic rochester criteria. these new criteria may facilitate adequate care of infants under 1 month of age who present with a history of fever.
%K bacterial infection
%K fever
%K bacteremia
%K neonate
%K risk evaluation.
%U http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S0034-75312007000300001&lng=en&nrm=iso&tlng=en