Nomura Osamu, Morikawa Yoshihiko, Mori Takaaki, Hagiwara Yusuke, Sakakibara Hiroshi, Horikoshi Yuho, Inoue Nobuaki
Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo 183-8561, Japan.
Department of Emergency and Disaster Medicine, Hirosaki University, Aomori 036-8562, Japan.
Children (Basel). 2021 Nov 3;8(11):1003. doi: 10.3390/children8111003.
(1) Background: Young infants have a high risk of serious infection. The Systematic Inflammatory Response Syndrome (SIRS) criteria can be useful to identify both serious bacterial and viral infections. The aims of this study were to evaluate the diagnostic performance of the SIRS criteria for identifying serious infections in febrile young infants and to identify potential clinical predictors of such infections. (2) Methods: We conducted this prospective cohort study including febrile young infants (aged < 90 days) seen at the emergency department with a body temperature of 38.0 °C or higher. We calculated the diagnostic performance parameters and conducted the logistic regression analysis to identify the predictors of serious infection. (3) Results: Of 311 enrolled patients, 36.7% ( = 114) met the SIRS criteria and 28.6% ( = 89) had a serious infection. The sensitivity, specificity, positive predictive value, and positive likelihood ratio of the SIRS criteria for serious infection was 45.9%, 69.4%, 43.5%, 71.4%, 1.5, and 0.8, respectively. Logistic regression showed that male gender, body temperature ≥ 38.5 °C, heart rate ≥ 178 bpm, and age ≤ 50 days were significant predictors. (4) Conclusions: The performance of the SIRS criteria for predicting serious infections among febrile young infants was poor.
（1）背景：小婴儿发生严重感染的风险很高。系统性炎症反应综合征（SIRS）标准有助于识别严重的细菌和病毒感染。本研究的目的是评估SIRS标准在识别发热小婴儿严重感染方面的诊断性能，并确定此类感染的潜在临床预测因素。（2）方法：我们开展了这项前瞻性队列研究，纳入了在急诊科就诊的体温达到或高于38.0°C的发热小婴儿（年龄<90天）。我们计算了诊断性能参数，并进行逻辑回归分析以确定严重感染的预测因素。（3）结果：在311名入组患者中，36.7%（n = 114）符合SIRS标准，28.6%（n = 89）发生了严重感染。SIRS标准对严重感染的敏感性、特异性、阳性预测值和阳性似然比分别为45.9%、69.4%、43.5%、71.4%、1.5和0.8。逻辑回归显示，男性、体温≥38.5°C、心率≥178次/分钟和年龄≤50天是显著的预测因素。（4）结论：SIRS标准在预测发热小婴儿严重感染方面的性能较差。
