• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Infectious Disease

Clinical and biomarker-based diagnostic model identifies serious bacterial infections

byMatthew Lin, MDandCordelia Ross
July 6, 2017
in Infectious Disease, Pediatrics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Researchers derived a multivariable model, which included clinical and biomarker variables, found to be internally validated in terms of its ability to discriminate between pneumonia vs. no serious bacterial infection (SBI), and SBI vs. no SBI.

2. A diagnostic model for identifying SBIs, previous described by Nijman et al in 2011, was externally validated and was found to have increased accuracy when biomarkers such as procalcitonin and resistin were added to the model.

Evidence Rating: 1 (Excellent)

Study Rundown: For pediatric patients, acute febrile illness is a leading reason for emergency department visits. While the majority of these presentations are due to benign, self-limiting illnesses, a small percentage of these patients will have a SBI. At present, there is no universal model available for diagnosing SBIs. In this prospective, diagnostic accuracy study, researchers aimed to derived a multivariable model that incorporated clinical and biomarker variables and to assess its accuracy in diagnosing SBIs in febrile children <16 years of age. Additionally, using their own data set, researchers externally validated a model previously published by Nijman et al in 2011, that included predefined variables of age, duration of fever, tachycardia, temperature, tachypnea, ill-appearance, retractions, prolonged capillary refill, oxygenation saturation <94%, and C-reaction protein (CRP). The researchers’ newly derived diagnostic model performed well on internal validation in discriminating between pneumonia vs. no SBI and SBI vs. no SBI. Nijman et al’s model was externally validated with this patient population, and the discriminatory ability increased for pneumonia vs. no SBI and SBI vs. no SBI when the model was expanded to include procalcitonin and resistin. This study suggests that risk prediction models that incorporate clinical and biochemical markers may have utility in identifying SBIs, and thus in improving decision-making in the management of febrile children in the ER.

Click to read the study, published today in Pediatrics

Relevant Reading: Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: a diagnostic study

In-Depth [cross-sectional study]: This single-center prospective diagnostic accuracy study identified 1872 eligible subjects, of whom 1101 were recruited for analysis between November 2010 and April 2012. The study included children <16 years of age with fever (>38C) or history of fever who required blood tests as part of clinical management. Children with primary immunodeficiency were excluded. Diagnosis of SBI was made independently by both a research fellow and infectious disease consultant, based on composite reference standards that incorporated clinical, microbiological and radiologic data. Of 1101 subjects, 264 (24%) had SBIs. Researchers evaluated their own model using concordance statistics (c statistic), a number equal to the area under the receiver operator curve. Their derived model discriminated well on internal validation (c statistic 0.84; 95% CI = 0.78-0.90 for pneumonia; and 0.77, 95% CI = 0.71-0.83 for other SBIs). The Nijman model showed good discrimination between SBI and no SBI (c statistic=0.76), but stronger discrimination between pneumonia and no SBI (c statistic=0.85). When the model was expanded to include procalcitonin and resistin, discriminatory strength increased for distinguishing pneumonia vs. no SBI (c statistic=0.90) and SBI vs. no SBI (c statistic=0.84). Of the 1101 subjects, approximately 80% were admitted to the hospital and received antibiotics, with 60% not actually having SBIs.

RELATED REPORTS

Ambient air pollution associated with increased risk of Kawasaki disease in children

#VisualAbstract: Canakinumab treatment did not reduce pain to clinical significance but shows anti-inflammatory effects in children and young adults with sickle cell anemia

2 Minute Medicine Rewind April 13, 2022

Image: CC

©2017 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: pediatricspneumoniaquality improvementserious bacterial infections
Previous Post

2 Minute Medicine Rewind July 3, 2017

Next Post

Lower rates of hypoglycemia in patients treated with insulin degludec

RelatedReports

Isolated mild/moderate thrombocytopenia may not require intervention
Pediatrics

Ambient air pollution associated with increased risk of Kawasaki disease in children

May 9, 2022
#VisualAbstract: Canakinumab treatment did not reduce pain to clinical significance but shows anti-inflammatory effects in children and young adults with sickle cell anemia
StudyGraphics

#VisualAbstract: Canakinumab treatment did not reduce pain to clinical significance but shows anti-inflammatory effects in children and young adults with sickle cell anemia

May 4, 2022
Late gestation antidepressant use linked to postpartum hemorrhage
Weekly Rewinds

2 Minute Medicine Rewind April 13, 2022

April 18, 2022
Prescription of antibiotics for acute respiratory infections increasing
Infectious Disease

Clinical response to Gram stain-guided antibiotic therapy noninferior to that of guideline-based therapy in patients with ventilator-associated pneumonia

April 14, 2022
Next Post

Lower rates of hypoglycemia in patients treated with insulin degludec

Molecular testing for Clostridium difficile may not predict disease activity

Demand for FMT likely to increase with rise in multiply recurrent C. difficile cases

Fatty liver disease may independently predict high-risk coronary disease

Combination treatment with calcineurin inhibitors and IL-2 enhances transplant survival [PreClinical]

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Wellness Check: Mental Health
  • #VisualAbstract: Addition of elotuzumab to lenalidomide and dexamethasone did not significantly improve survival outcomes in newly diagnosed, transplant-ineligible multiple myeloma
  • #VisualAbstract: Pretreatment with radiotherapy and two cycles of concurrent cisplatin may reduce toxicity in locally advanced nasopharyngeal carcinoma
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.