发热高度与侵袭性细菌感染。
Height of fever and invasive bacterial infection.
机构信息
Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
出版信息
Arch Dis Child. 2021 Jun;106(6):594-596. doi: 10.1136/archdischild-2019-318548. Epub 2020 Aug 20.
OBJECTIVE
We aimed to evaluate the association of height of fever with invasive bacterial infection (IBI) among febrile infants <=60 days of age.
METHODS
In a secondary analysis of a multicentre case-control study of non-ill-appearing febrile infants <=60 days of age, we compared the maximum temperature (at home or in the emergency department) for infants with and without IBI. We then computed interval likelihood ratios (iLRs) for the diagnosis of IBI at each half-degree Celsius interval.
RESULTS
The median temperature was higher for infants with IBI (38.8°C; IQR 38.4-39.2) compared with those without IBI (38.4°C; IQR 38.2-38.9) (p<0.001). Temperatures 39°C-39.4°C and 39.5°C-39.9°C were associated with a higher likelihood of IBI (iLR 2.49 and 3.40, respectively), although 30.4% of febrile infants with IBI had maximum temperatures <38.5°C.
CONCLUSIONS
Although IBI is more likely with higher temperatures, height of fever alone should not be used for risk stratification of febrile infants.
目的
评估发热高度与 60 天以下发热婴儿侵袭性细菌感染（IBI）的关系。
方法
对多中心非病容发热婴儿（60 天以下）的病例对照研究进行二次分析，比较 IBI 婴儿与无 IBI 婴儿的最大体温（在家或急诊室）。然后计算每个半摄氏度间隔的诊断 IBI 的间隔似然比（iLR）。
结果
与无 IBI 的婴儿相比（38.4°C；IQR 38.2-38.9），有 IBI 的婴儿的中位体温更高（38.8°C；IQR 38.4-39.2）（p<0.001）。体温在 39°C-39.4°C 和 39.5°C-39.9°C 时与更高的 IBI 可能性相关（iLR 分别为 2.49 和 3.40），尽管 30.4%的 IBI 发热婴儿的最高体温<38.5°C。
结论
尽管体温越高，发生 IBI 的可能性越大，但发热高度不应单独用于发热婴儿的风险分层。
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