WIP 76 - Does a positive Respiratory Viral Panel decrease the risk of serious bacterial infections in febrile neonates?

Publication Number: WIP 76.7408

Diormi Rosario, Maimonides Infants and Children's Hospital of Brooklyn, new york, NY, United States; Anum N. Mitha, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, NY, United States; Hector Vazquez, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, NY, United States; Jessica Zerzan, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, NY, United States; Saxony Busta, CHOC Children's Hospital of Orange County, Huntington Beach, CA, United States; Sharmilaa Babu, Duke University School of Medicine, Durham, NC, United States; Cristina Bravi, Hassenfeld Children's Hospital at NYU Langone, New York, NY, United States

Background: The evaluation of febrile infants is a subject of ongoing controversy within the realm of pediatric emergency medicine. The challenge lies in the uncertainty surrounding whether clinical indications of a viral infection can reliably reduce the risk of serious bacterial infections (SBIs). The significance of investigating the inclusion of Respiratory Viral Panel (RVP) testing in the AAP guidelines lies in its potential to revolutionize the diagnostic paradigm for febrile neonates. Ultimately, the findings from this investigation may pave the way for the development of enhanced and tailored clinical guidelines, further improving the quality of care provided to this vulnerable population in the pediatric emergency setting.

Objective: Compare the rates of serious bacterial infection (SBI) in infants less than or equal to 60 days old with a positive respiratory viral panel (RVP) to those with a negative viral panel in the setting of a fever.

Design/Methods: Subjects:
Patients between 0-60 DO who presented to the ED with fever from March 1, 2020 to December 31, 2023
Design:
Single-center, retrospective cohort study at Maimonides Medical Center Emergency Department comparing the data from 2020-2023
Data Collection Procedures:
SCM data from March 1, 2020 to December 31, 2023. Search all patients with chief complaint fever, documented fever of ≥ 100.4F, or diagnosis of fever, sepsis, UTI, bacteremia, and meningitis. Gather data on these patients including demographics, lab values, ICD-10 diagnosis, antibiotics administered, disposition, and length of hospitalization
Data Analysis:
Compare the rates of SBI in those with a positive vs negative RVP
Will summarize continuous variables using medians and interquartile ranges and categorical data with proportions
Sample Size:
Anticipate at least 120 patients per arm, roughly 240 patients
Expected Outcomes:
Patients with a positive RVP will be at a lower risk for SBIs compared to those with a negative result
Timetable:
Data should be completed by November and will then begin to work on abstract