315 - Risk of Serious Bacterial Infection in Hypothermic Young Infants with Positive Respiratory Pathogen Testing

Poster Number: 315
Publication Number: 315.213

Madhuri G. Prasad, Johns Hopkins All Children's Hospital, St. Petersburg, FL, United States; Sanford Williams, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; John M. Morrison, Johns Hopkins All Children's Hospital, Saint Petersburg, FL, United States; Sumeet L. Banker, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Meghan Gray, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; Noah Hellermann, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Julie K. Wood, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Annalise Van Meurs, Doernbecher Children's Hospital at Oregon Health & Science University, Portland, OR, United States; Kathryn Westphal, Pediatrics, Columbus, OH, United States; Vignesh Doraiswamy, Ohio State University College of Medicine, Columbus, OH, United States; Meenu Sharma, Children's of Alabama, Birmingham, AL, United States; Stephanie Berger, University of Alabama School of Medicine, Birmingham, AL, United States; Jennifer Raffaele, Prisma Health Upstate, University of South Carolina School of Medicine Greenville, Taylors, SC, United States; Meredith Mitchell, Children's Hospital of Richmond at VCU, Richmond, VA, United States; Clifton Lee, Virginia Commonwealth University School of Medicine, Richmond, VA, United States; Monica Mattes, Children's Hospital Los Angeles, LOS ANGELES, CA, United States; Kira Molas-Torreblanca, Children's Hospital Los Angeles, Los Angeles, CA, United States; Joseph Ewing, Prisma Health, Greenville, SC, United States; Elizabeth E. Halvorson, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Nicholas M. Potisek, University of South Carolina School of Medicine Greenville, Greenville, SC, United States; On Behalf of the Hypothermic Young Infant Research Collaborative, University of South Carolina School of Medicine Greenville, Greenville, SC, United States

Background: Hypothermia may be a presenting symptom in young infants with serious bacterial infections (SBI). Positive respiratory pathogen (RP) testing in well-appearing febrile infants is associated with reduced risk of SBI. However, it is unknown whether positive testing is similarly associated with reduced risk of SBI in infants presenting with hypothermia.

Objective: Determine the association between positive RP testing and risk of SBI in infants ≤90 days presenting to care with hypothermia.

Design/Methods: We conducted a multi-center retrospective cohort study of children ≤90 days presenting to an emergency department or directly admitted to the hospital from September 1, 2016 to May 5, 2021 with measured or historical hypothermia (≤36oC) prior to or upon arrival. Patients with hypothermia in the NICU or nursery, a central line, known trauma, fever, no RP panel obtained, or inaccessible culture results were excluded. Positive RP testing included positive single and multiplex nucleic acid amplification testing performed at each site. The primary outcome monitored was development of SBI, defined as positive blood, urine, or cerebrospinal (CSF) culture. Patient demographic and clinical characteristics, clinical course, and prevalence of SBI were compared between those with and without positive RP testing with Chi-squared tests.

Results: Approximately 29 % (184/632) of hypothermic infants received RP testing, of which, 63 (34%) had a positive result (RP+). Infants with a positive result were more often 7 days or older (95% vs 54%; pConclusion(s): The majority of hypothermic infants did not have RP testing performed. We did not find a reduced risk of SBI in hypothermic infants with a +RP. Hypothermic infants ≥7 days of age presenting for care during fall and winter months more often tested positive for a RP. Data collection is ongoing to expand this cohort and improve statistical power.
CVCV.pdf
Table 2Prevalence of serious bacterial infection and invasive bacterial infection by respiratory pathogen panel testing result and age.