Predictors and Outcome of Admission for Invasive Streptococcus pneumoniae Infections at a Canadian Children's Hospital
Identifieur interne : 001D66 ( Istex/Curation ); précédent : 001D65; suivant : 001D67Predictors and Outcome of Admission for Invasive Streptococcus pneumoniae Infections at a Canadian Children's Hospital
Auteurs : Kevin B. Laupland [Canada] ; H. Dele Davies [Canada] ; James D. Kellner [Canada] ; Nina-Lynn Luzod [Canada] ; Tulika Karan [Canada] ; Doreen Ma [Canada] ; Dina Taub [Canada] ; Cheri Nijssen-Jordan [Canada] ; Gary Katzko [Canada] ; Taj Jadavji [Canada] ; Deirdre Church [Canada]Source :
- Clinical Infectious Diseases [ 1058-4838 ] ; 1998-09.
Abstract
Rates of admission for invasive Streptococcus pneumoniae infection in children vary considerably between institutions. We performed a retrospective study to investigate factors used in the decision to admit patients with invasive S. pneumoniae infection to Alberta Children's Hospital. Of 254 patients who were initially assessed in the emergency department, 38.2% were admitted to the hospital. Significant risk factors for admission as determined by a logistic regression model included murmur (odds ratio [OR], 18.98; 95% confidence interval [CI], 4.08–88.23), focal infection (OR, 11.41; 95% CI, 5.07–25.67), and older age (OR, 2.72; 95% CI, 1.03–7.17). Higher hemoglobin level (OR, 0.96; 95% CI, 0.93–0.99) and temperature of >38.5°C (OR, 0.39; 95% CI, 0.18–0.85) were associated with a lower risk of admission. Two patients died (case-fatality rate, 0.7%). Despite the low rate of admission for invasive S. pneumoniae infections at our hospital, the mortality rate was comparable with those at institutions with higher rates of admission, thus suggesting that the factors we identified may be useful in deciding whether to admit patients with (or who are at high risk for) invasive S. pneumoniae infections.
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DOI: 10.1086/514707
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Dele Davies</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Kellner, James D" sort="Kellner, James D" uniqKey="Kellner J" first="James D." last="Kellner">James D. 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Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Jadavji, Taj" sort="Jadavji, Taj" uniqKey="Jadavji T" first="Taj" last="Jadavji">Taj Jadavji</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Church, Deirdre" sort="Church, Deirdre" uniqKey="Church D" first="Deirdre" last="Church">Deirdre Church</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:F4EF6A5144391AF1B86131A0C213357753681D19</idno><date when="1998" year="1998">1998</date><idno type="doi">10.1086/514707</idno><idno type="url">https://api-v5.istex.fr/document/F4EF6A5144391AF1B86131A0C213357753681D19/fulltext/pdf</idno><idno 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Laupland</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Davies, H Dele" sort="Davies, H Dele" uniqKey="Davies H" first="H. Dele" last="Davies">H. Dele Davies</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Kellner, James D" sort="Kellner, James D" uniqKey="Kellner J" first="James D." last="Kellner">James D. Kellner</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Luzod, Nina Lynn" sort="Luzod, Nina Lynn" uniqKey="Luzod N" first="Nina-Lynn" last="Luzod">Nina-Lynn Luzod</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Karan, Tulika" sort="Karan, Tulika" uniqKey="Karan T" first="Tulika" last="Karan">Tulika Karan</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Ma, Doreen" sort="Ma, Doreen" uniqKey="Ma D" first="Doreen" last="Ma">Doreen Ma</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Taub, Dina" sort="Taub, Dina" uniqKey="Taub D" first="Dina" last="Taub">Dina Taub</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Nijssen Jordan, Cheri" sort="Nijssen Jordan, Cheri" uniqKey="Nijssen Jordan C" first="Cheri" last="Nijssen-Jordan">Cheri Nijssen-Jordan</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Katzko, Gary" sort="Katzko, Gary" uniqKey="Katzko G" first="Gary" last="Katzko">Gary Katzko</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Jadavji, Taj" sort="Jadavji, Taj" uniqKey="Jadavji T" first="Taj" last="Jadavji">Taj Jadavji</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author><author><name sortKey="Church, Deirdre" sort="Church, Deirdre" uniqKey="Church D" first="Deirdre" last="Church">Deirdre Church</name><affiliation wicri:level="1"><mods:affiliation>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>From the Departments of Microbiology and Infectious Diseases, Pediatrics, and Emergency Medicine, Alberta Children's Hospital, University of Calgary, Calgary, Alberta</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Clinical Infectious Diseases</title><title level="j" type="abbrev">Clinical Infectious Diseases</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><publisher>The University Chicago Press</publisher><date type="published" when="1998-09">1998-09</date><biblScope unit="volume">27</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="597">597</biblScope><biblScope unit="page" to="602">602</biblScope></imprint><idno type="ISSN">1058-4838</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1058-4838</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Rates of admission for invasive Streptococcus pneumoniae infection in children vary considerably between institutions. We performed a retrospective study to investigate factors used in the decision to admit patients with invasive S. pneumoniae infection to Alberta Children's Hospital. Of 254 patients who were initially assessed in the emergency department, 38.2% were admitted to the hospital. Significant risk factors for admission as determined by a logistic regression model included murmur (odds ratio [OR], 18.98; 95% confidence interval [CI], 4.08–88.23), focal infection (OR, 11.41; 95% CI, 5.07–25.67), and older age (OR, 2.72; 95% CI, 1.03–7.17). Higher hemoglobin level (OR, 0.96; 95% CI, 0.93–0.99) and temperature of >38.5°C (OR, 0.39; 95% CI, 0.18–0.85) were associated with a lower risk of admission. Two patients died (case-fatality rate, 0.7%). Despite the low rate of admission for invasive S. pneumoniae infections at our hospital, the mortality rate was comparable with those at institutions with higher rates of admission, thus suggesting that the factors we identified may be useful in deciding whether to admit patients with (or who are at high risk for) invasive S. pneumoniae infections.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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