PDF(Pubmed)
Abstract：
BACKGROUND: Serious bacterial infection rates in febrile infants < 60 days are about 8-11%. Less than 1% of febrile infants with no respiratory symptoms will have pneumonia however, chest radiography (CXR) rates remain between 30 and 60%. Rapid Respiratory Syncytial Virus (RSV) and influenza (flu) testing is common, however, there is not enough data to determine if febrile infants without any respiratory symptoms should be tested. The goal of this study is to determine the rate of positive CXR and RSV/flu results in febrile infants with no respiratory symptoms and no sick contacts.
METHODS: Well-appearing febrile infants between 7 and 60 days of age who presented to the pediatric emergency department (PED) from September 1st, 2015 through October 30th, 2017 were enrolled. Demographic data, respiratory symptoms, CXR findings and RSV/flu results were collected. SAS statistical software was used for analysis.
RESULTS: 129 infants met enrollment criteria. Of the 129 infants, 58 (45.0%) had no respiratory symptoms and no sick contacts. Of these 58, 36 (62.1%) received a CXR and none of them had any abnormal findings, 48 (82.8%) had RSV/flu testing, no patients tested positive for RSV and only one patient tested positive for flu. Costs of CXR and RSV/flu testing for this cohort was $19,788.
CONCLUSIONS: The absence of positive CXRs in this patient population reinforces the current recommendations that CXR is not indicated. The low incidence of RSV/flu indicate that routine testing may not be necessary in this population especially outside of the flu season. Reduced testing could decrease overall costs to the healthcare system as well as radiation exposure to this population.
METHODS: Well-appearing febrile infants between 7 and 60 days of age who presented to the pediatric emergency department (PED) from September 1st, 2015 through October 30th, 2017 were enrolled. Demographic data, respiratory symptoms, CXR findings and RSV/flu results were collected. SAS statistical software was used for analysis.
RESULTS: 129 infants met enrollment criteria. Of the 129 infants, 58 (45.0%) had no respiratory symptoms and no sick contacts. Of these 58, 36 (62.1%) received a CXR and none of them had any abnormal findings, 48 (82.8%) had RSV/flu testing, no patients tested positive for RSV and only one patient tested positive for flu. Costs of CXR and RSV/flu testing for this cohort was $19,788.
CONCLUSIONS: The absence of positive CXRs in this patient population reinforces the current recommendations that CXR is not indicated. The low incidence of RSV/flu indicate that routine testing may not be necessary in this population especially outside of the flu season. Reduced testing could decrease overall costs to the healthcare system as well as radiation exposure to this population.
摘要：
背景：60天以下发热婴儿的严重细菌感染率约为8-11%。然而，没有呼吸道症状的发热婴儿中不到1%会出现肺炎，胸部X线摄影（CXR）率保持在30％至60％之间。快速呼吸道合胞病毒（RSV）和流感（流感）检测很常见，然而,没有足够的数据来确定是否应该对没有任何呼吸道症状的发热婴儿进行测试。这项研究的目的是确定无呼吸道症状且无患病接触的发热婴儿的CXR和RSV/流感结果阳性率。
方法：从9月1日起到儿科急诊科（PED）就诊的7至60天大的发热婴儿，2015年10月30日,2017年报名。人口统计数据,呼吸道症状,收集CXR结果和RSV/流感结果。采用SAS统计软件进行分析。
结果：129名婴儿符合登记标准。在129个婴儿中，58（45.0％）没有呼吸道症状，也没有生病的接触。在这58,36人(62.1%)接受了CXR，没有人出现异常，48人(82.8%)接受了RSV/流感检测，没有患者的RSV检测呈阳性,只有一名患者的流感检测呈阳性.该队列的CXR和RSV/流感测试费用为19,788美元。
结论：在该患者人群中不存在阳性CXR，这加强了目前不需要CXR的建议。RSV/流感的低发病率表明，在该人群中，尤其是在流感季节之外，常规测试可能是不必要的。减少测试可以降低医疗保健系统的总成本以及对该人群的辐射暴露。
方法：从9月1日起到儿科急诊科（PED）就诊的7至60天大的发热婴儿，2015年10月30日,2017年报名。人口统计数据,呼吸道症状,收集CXR结果和RSV/流感结果。采用SAS统计软件进行分析。
结果：129名婴儿符合登记标准。在129个婴儿中，58（45.0％）没有呼吸道症状，也没有生病的接触。在这58,36人(62.1%)接受了CXR，没有人出现异常，48人(82.8%)接受了RSV/流感检测，没有患者的RSV检测呈阳性,只有一名患者的流感检测呈阳性.该队列的CXR和RSV/流感测试费用为19,788美元。
结论：在该患者人群中不存在阳性CXR，这加强了目前不需要CXR的建议。RSV/流感的低发病率表明，在该人群中，尤其是在流感季节之外，常规测试可能是不必要的。减少测试可以降低医疗保健系统的总成本以及对该人群的辐射暴露。
