Late-Onset GBS Bacteremia: Pediatric ED & Infection

A multicenter prospective registry observational research and subanalysis. The scene: a pediatric emergency room. Infants aged 7 to 89 days with positive blood culture for GBS between 2011 and 2016 at 22 pediatric emergency departments (PEDs) were eligible. Main outcome: risk factors for severe infection (sepsis/septic shock or meningitis) and PICU admission (clinical and laboratory data). Second, there was a high prevalence of adverse outcomes (acute complications, sequelae, or death). About 74 (62.7%) of the 118 patients with LOD had a severe illness, including 66 sepsis/septic shock (11 with concomitant meningitis) and eight meningitis. A total of 35 patients (29.7%) were admitted to a PICU. The only independent risk factors for severe infection [odds ratio (OR): 43.6; 95% CI: 8.1–235.7, P<0.01] and PICU admission (OR: 11.6; 95% CI: 1.5–91.4; P< 0.019) were an altered Pediatric Assessment Triangle (PAT) upon arrival and leukopenia. About 6 patients (5.1%) had a poor prognosis, including two fatalities (1.7%); all had a changed PAT, increased procalcitonin (range 4.7–100 ng/ml), and were diagnosed with sepsis/septic shock and were sent to a PICU. Leukopenia struck 4 people. Sepsis/septic shock and bacterial meningitis were common in infants with GBS LOD and were associated with significant morbidity and mortality. The only risk factor for severe infection was the clinical presentation, although leukopenia was linked to PICU admission.

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