2025
Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections.
Aronson P, Mahajan P, Meeks H, Nielsen B, Olsen C, Casper T, Grundmeier R, Kuppermann N. Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections. 2025, 156 PMID: 40854562, PMCID: PMC12432541, DOI: 10.1542/peds.2025-071666.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsAbsolute neutrophil countLow risk of invasive bacterial infectionRisk of invasive bacterial infectionsClinical prediction ruleFebrile infantsLow riskPediatric Emergency Care Applied Research Network RegistryPrediction ruleBacterial infectionsAnalysis to infantsCerebrospinal fluid culturesLow-risk infantsBlood culturesNegative urinalysisFluid cultureHealthy infantsBacterial meningitisNeutrophil countProspective validationBlood testsProcalcitoninNetwork registryInfantsEmergency departmentRisk of Bacterial Infections in Febrile Infants 61 to 90 Days Old With Respiratory Viruses.
Aronson P, Mahajan P, Nielsen B, Olsen C, Meeks H, Grundmeier R, Kuppermann N. Risk of Bacterial Infections in Febrile Infants 61 to 90 Days Old With Respiratory Viruses. 2025, 156 PMID: 40506050, PMCID: PMC12410455, DOI: 10.1542/peds.2025-070617.Peer-Reviewed Original ResearchConceptsPrevalence of urinary tract infectionUrinary tract infectionPediatric Emergency Care Applied Research NetworkRespiratory viral testingRespiratory viral infectionsFebrile infantsBacterial meningitisRespiratory virusesSARS-CoV-2Viral testingViral infectionSARS-CoV-2-positive infantsBacterial infectionsRisk of bacterial infectionPrevalence of bacteremiaPrevalence of bacterial infectionRespiratory syncytial virusBlood culturesTract infectionsPositive infantsSyncytial virusNegative infantsBacteremiaMeningitisInfantsUrine Dipstick for the Diagnosis of Urinary Tract Infection in Febrile Infants Aged 2 to 6 Months.
Hunt K, Green R, Sartori L, Aronson P, Chamberlain J, Florin T, Michelson K, Monuteaux M, Chaudhari P, Nigrovic L. Urine Dipstick for the Diagnosis of Urinary Tract Infection in Febrile Infants Aged 2 to 6 Months. 2025, 155 PMID: 40122108, DOI: 10.1542/peds.2024-068671.Peer-Reviewed Original ResearchConceptsDiagnosis of urinary tract infectionUrinary tract infectionUrine WBC countUrine dipstickUrine cultureAged 2 to 6Receiver Operating CharacteristicWhite blood cellsTract infectionsColony-forming unitsUrine white blood cellsWBC countCatheterized urine culturePositive urine dipstickInitial treatment decisionsAccurate diagnostic testCross-sectional studyBacterial uropathogensFebrile infantsLaboratory urinalysisTreatment decisionsDiagnostic testsEmergency departmentUrinalysisUrine
2024
Natural Language Processing to Identify Infants Aged 90 Days and Younger With Fevers Prior to Presentation.
Aronson P, Kuppermann N, Mahajan P, Nielsen B, Olsen C, Meeks H, Grundmeier R. Natural Language Processing to Identify Infants Aged 90 Days and Younger With Fevers Prior to Presentation. Hospital Pediatrics 2024, 15: e1-e5. PMID: 39679596, PMCID: PMC12163744, DOI: 10.1542/hpeds.2024-008051.Peer-Reviewed Original ResearchElectronic health recordsEmergency departmentNatural language processing algorithmsElectronic health record dataPediatric Emergency Care Applied Research Network RegistryFebrile infantsNatural language processingCross-sectional studyTrauma-related diagnosesPositive predictive valueHealth recordsHealth systemDocumented feverClinical notesPre-EDNetwork registryCohort identificationVisitsLanguage processingNLP algorithmsPredictive valueInfantsFeverResearch studiesDiagnostic Performance of AAP-Recommended Inflammatory Markers in Febrile Infants Aged 60 Days or Younger.
Yankova L, McDaniel C, Kerns E, Shine A, Ruiz B, Caruso H, Aronson P. Diagnostic Performance of AAP-Recommended Inflammatory Markers in Febrile Infants Aged 60 Days or Younger. 2024, 155 PMID: 39636262, PMCID: PMC12409484, DOI: 10.1542/peds.2024-068856.Peer-Reviewed Original ResearchDisposition and Follow-up for Low-Risk Febrile Infants: A Secondary Analysis of a Multicenter Study.
Kannikeswaran N, Spencer P, Tedford N, Truschel L, Chu J, Dingeldein L, Waseem M, Chow J, Lababidi A, Theiler C, Bhalodkar S, Yan X, Lou X, Fernandez R, Aronson P, Lion K, Gutman C. Disposition and Follow-up for Low-Risk Febrile Infants: A Secondary Analysis of a Multicenter Study. Hospital Pediatrics 2024, 14: e379-e384. PMID: 39113626, PMCID: PMC11358591, DOI: 10.1542/hpeds.2024-007850.Peer-Reviewed Original ResearchConceptsFebrile infantsFollow-upPrimary care providersElectronic health record documentationElectronic health recordsDischarged infantsEmergency departmentED dispositionLow riskAmerican Academy of Pediatrics guidelinesInvasive bacterial infectionsSecondary analysisCross-sectional studyMulticenter studyPost-discharge follow-upPediatric guidelinesWeekday visitsBacterial infectionsInfantsQuality of careAmerican AcademyMulticenterCare planningCare providersPatient-centeredImproving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative.
McDaniel C, Kerns E, Jennings B, Magee S, Biondi E, Flores R, Aronson P. Improving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative. 2024, 153 PMID: 38682245, DOI: 10.1542/peds.2023-063339.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesFebrile infantsAmerican Academy of Pediatrics clinical practice guidelineSecondary measuresAAP clinical practice guidelinesPediatrics clinical practice guidelineInvasive bacterial infectionsQI collaborativeIntervention bundleAdherence to specific recommendationsDischarge of infantsGuideline-concordant careInfants aged 8Clinical practice guideline recommendationsPrimary measureQuality improvementOral antibioticsEmergency department dischargePositive urinalysisAssociated with improvementsQualifying infantsQuality improvement initiativesAdministered antibioticsGuideline recommendationsCerebrospinal fluidContaminant Organism Growth in Febrile Infants at Low Risk for Invasive Bacterial Infection
Singh N, Gutman C, Green R, Thompson A, Jackson K, Kalari N, Lucrezia S, Krack A, Corboy J, Cheng T, Duong M, St Pierre-Hetz R, Akinsola B, Kelly J, Sartori L, Yan X, Lou X, Lion K, Fernandez R, Aronson P, Group P. Contaminant Organism Growth in Febrile Infants at Low Risk for Invasive Bacterial Infection. The Journal Of Pediatrics 2024, 267: 113910. PMID: 38218368, PMCID: PMC12403202, DOI: 10.1016/j.jpeds.2024.113910.Peer-Reviewed Original Research
2023
Clinician Management Practices for Infants With Hypothermia in the Emergency Department.
Ramgopal S, Graves C, Aronson P, Cruz A, Rogers A. Clinician Management Practices for Infants With Hypothermia in the Emergency Department. 2023, 152 PMID: 38009075, DOI: 10.1542/peds.2023-063000.Peer-Reviewed Original ResearchConceptsSerious bacterial infectionsManagement of infantsEmergency departmentTreatment preferencesRespiratory viral testingSimplex virus infectionUS pediatric hospitalsProportion of cliniciansDays of ageClinician testingFebrile infantsED cliniciansInfants 0Pediatric hospitalViral testingClinician comfortVirus infectionAntimicrobial administrationHypothermiaYoung infantsOlder infantsInfantsBacterial infectionsCliniciansAgePrevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2
Aronson P, Louie J, Kerns E, Jennings B, Magee S, Wang M, Gupta N, Kovaleski C, McDaniel L, McDaniel C, Agbim C, Amadasun O, Beam N, Beamon B, Becker H, Bedard E, Biondi E, Boulet J, Bray-Aschenbrenner A, Brooks R, Chen C, Corboy J, Dawlabani N, De Angulo G, Demie S, Drexler J, Dudley N, Ellis A, Fath K, Frauenfelder A, Gill J, Graf T, Grageda M, Greening H, Griffin A, Groen A, Guernsey III D, Gustafson S, Hancock W, Iyer S, Jaiyeola P, Jayanth A, Jennings R, Kachan-Liu S, Kamat A, Kennedy I, Khateeb L, Khilji O, Kleweno E, Kumar A, Kwon S, La A, Laeven-Sessions P, Le K, Leazer R, Levasseur K, Lewis E, Maalouli W, Mackenzie B, Mahoney K, Margulis D, Maskin L, McCarty E, Monroy A, Morrison J, Myszewski J, Nadeau N, Nagappan S, Newcomer K, Nordstrom M, Nguyen D, O'Day P, Oumarbaeva-Malone Y, Parlin U, Peters S, Piroutek M, Quarrie R, Rice K, Romano T, Rooholamini S, Schroeder C, Segar E, Seitzinger P, Sharma S, Simpson B, Singh P, Sobeih Y, Sojar S, Srinivasan K, Sterrett E, Swift-Taylor M, Szkola S, Thull-Freedman J, Topoz I, Vayngortin T, Veit C, Ventura-Polanco Y, Wallace Wu A, Weiss L, Wong E, Zafar S. Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2. JAMA Network Open 2023, 6: e2313354. PMID: 37171815, PMCID: PMC10182434, DOI: 10.1001/jamanetworkopen.2023.13354.Peer-Reviewed Original ResearchConceptsPrevalence of UTIUrinary tract infectionSARS-CoV-2SARS-CoV-2-positive infantsSARS-CoV-2 testingFebrile infantsBacterial meningitisTract infectionsSARS-CoV-2 positivityMulticenter cross-sectional studyInflammatory marker levelsMedical record reviewProportion of infantsCross-sectional studyQuality improvement initiativesRecord reviewEmergency departmentMarker levelsLower proportionBacteremiaMAIN OUTCOMEMeningitisInfantsAge groupsBacterial infections149 A Mixed Methods Analysis of Disparities in the Management of Low-Risk Febrile Infants
Gutman C, Aronson P, Lion K, Fisher C, McFarlane A, Bylund C, Fernandez R. 149 A Mixed Methods Analysis of Disparities in the Management of Low-Risk Febrile Infants. Journal Of Clinical And Translational Science 2023, 7: 45-45. PMCID: PMC10129715, DOI: 10.1017/cts.2023.230.Peer-Reviewed Original ResearchLow-risk febrile infantsStandard of careFebrile infantsPhysician-parent communicationMulticenter cross-sectional studyInvasive bacterial infectionsPediatric emergency departmentCross-sectional studyEmergency departmentLumbar puncturePhysician interviewsModifiable targetsModifiable driversProfessional interpretationInfant raceInfantsBacterial infectionsPhysician behaviorHealth disparitiesLogistic regressionHealth equityFuture interventionsCareInfluence management decisionsResults/
2022
Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic.
Aronson P, Kerns E, Jennings B, Magee S, Wang M, McDaniel C. Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic. 2022, 150 PMID: 36353853, DOI: 10.1542/peds.2022-059235.Peer-Reviewed Original ResearchConceptsUrinary tract infectionInvasive bacterial infectionsCOVID-19 prevalenceFebrile infantsOdds of UTIPrevalence of UTIBacterial infectionsMulticenter cross-sectional studyEmergency department visitsMonths of presentationCoronavirus disease 2019 (COVID-19) pandemicCross-sectional studyDisease 2019 pandemicUTI prevalenceTract infectionsBacterial meningitisDepartment visitsLower oddsPrepandemic levelsInfantsInfants 8MeningitisBacteremiaLogistic regressionPrevalenceDisparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol
Gutman C, Lion K, Aronson P, Fisher C, Bylund C, McFarlane A, Lou X, Patterson M, Lababidi A, Fernandez R. Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol. BMJ Open 2022, 12: e063611. PMID: 36127098, PMCID: PMC9490627, DOI: 10.1136/bmjopen-2022-063611.Peer-Reviewed Original ResearchConceptsLow-risk febrile infantsFebrile infantsEmergency departmentClinical carePediatric Emergency Medicine Collaborative Research CommitteeFlorida Institutional Review BoardLocal institutional review board approvalPediatric ED physiciansInstitutional review board approvalMultivariable logistic regressionCross-sectional studyPhysician-patient communicationReview board approvalClinical guideline implementationMethods study protocolInstitutional review boardMulticenter analysisPrimary outcomeED physiciansPhysician assessmentRecommended careGuideline implementationLumbar punctureStudy protocolEmergency settingPrevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months
Green R, Sartori L, Lee B, Linn A, Samuels M, Florin T, Aronson P, Chamberlain J, Michelson K, Nigrovic L. Prevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months. Annals Of Emergency Medicine 2022, 80: 499-506. PMID: 35940993, DOI: 10.1016/j.annemergmed.2022.06.014.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsCase-control studyBacterial infectionsFebrile infantsInfants 2Emergency departmentEligible patient encountersOlder febrile infantsCerebrospinal fluid culturesInfection prevalenceAge-matched infantsEvidence-based guidelinesInfants ages 2Months of ageLow-value testingFebrile neonatesOverall cohortRetrospective cohortSecondary outcomesPrimary outcomeAntibiotic administrationBacterial cultureFluid cultureCerebrospinal fluidLower risk
2020
Febrile Infants ≤60 Days Old With Positive Urinalysis Results and Invasive Bacterial Infections
Yankova LC, Neuman MI, Wang ME, Woll C, DePorre AG, Desai S, Sartori LF, Nigrovic LE, Pruitt CM, Marble RD, Leazer RC, Rooholamini SN, Balamuth F, Aronson PL. Febrile Infants ≤60 Days Old With Positive Urinalysis Results and Invasive Bacterial Infections. Hospital Pediatrics 2020, 10: 1120-1125. PMID: 33239319, PMCID: PMC7684554, DOI: 10.1542/hpeds.2020-000638.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsAbnormal WBC countPositive urinalysis resultsFebrile infantsUrinalysis resultsWBC countIll appearanceBacterial meningitisAbnormal white blood cell countBacterial infectionsWhite blood cell countConcomitant bacterial meningitisCerebrospinal fluid pleocytosisRetrospective cohort studyUrinary tract infectionPlanned secondary analysisBlood cell countCohort studyLaboratory characteristicsTract infectionsEmergency departmentMost infantsMedical historyLower riskMeningitisDevelopment of an App to Facilitate Communication and Shared Decision‐making With Parents of Febrile Infants ≤ 60 Days Old
Aronson PL, Politi MC, Schaeffer P, Fleischer E, Shapiro ED, Niccolai LM, Alpern ER, Bernstein SL, Fraenkel L. Development of an App to Facilitate Communication and Shared Decision‐making With Parents of Febrile Infants ≤ 60 Days Old. Academic Emergency Medicine 2020, 28: 46-59. PMID: 32648270, PMCID: PMC7794092, DOI: 10.1111/acem.14082.Peer-Reviewed Original ResearchPredictive factors for bacteremia in febrile infants with urinary tract infection
Yoon S, Shin H, Lee K, Kim M, Kim D, Ahn J, Shin J. Predictive factors for bacteremia in febrile infants with urinary tract infection. Scientific Reports 2020, 10: 4469. PMID: 32161316, PMCID: PMC7066144, DOI: 10.1038/s41598-020-61421-4.Peer-Reviewed Original ResearchConceptsBacteremic urinary tract infectionUrinary tract infectionC-reactive proteinNon-bacteremic urinary tract infectionPresence of vesicoureteral refluxVesicoureteral refluxFebrile infantsTract infectionsBlood urea nitrogenPredictive factorsCulture-proven urinary tract infectionFebrile urinary tract infectionLevels of C-reactive proteinC-reactive protein levelsC-reactive protein valuesEvaluating vesicoureteral refluxMultivariate logistic regression analysisLow platelet countDelta neutrophil indexRetrospective cohort studyUnivariate logistic analysisReceiver operating characteristic curveLogistic regression analysisConcomitant bacteremiaUTI groupParents' Perspectives on Communication and Shared Decision Making for Febrile Infants ≤60 Days Old
Aronson PL, Schaeffer P, Niccolai LM, Shapiro ED, Fraenkel L. Parents' Perspectives on Communication and Shared Decision Making for Febrile Infants ≤60 Days Old. Pediatric Emergency Care 2020, 37: e1213-e1219. PMID: 31977772, PMCID: PMC7371504, DOI: 10.1097/pec.0000000000001977.Peer-Reviewed Original Research
2019
A Prediction Model to Identify Febrile Infants ≤60 Days at Low Risk of Invasive Bacterial Infection
Aronson PL, Shabanova V, Shapiro ED, Wang ME, Nigrovic LE, Pruitt CM, DePorre AG, Leazer RC, Desai S, Sartori LF, Marble RD, Rooholamini SN, McCulloh RJ, Woll C, Balamuth F, Alpern ER, Shah SS, Williams DJ, Browning WL, Shah N, Neuman MI. A Prediction Model to Identify Febrile Infants ≤60 Days at Low Risk of Invasive Bacterial Infection. 2019, 144: e20183604. PMID: 31167938, PMCID: PMC6615531, DOI: 10.1542/peds.2018-3604.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsAbsolute neutrophil countFebrile infantsControl patientsNeutrophil countUrinalysis resultsBacterial infectionsAbnormal urinalysis resultsNormal urinalysis resultsComplex chronic conditionsCase-control studyMultiple logistic regressionDate of visitEmergency departmentChronic conditionsCerebrospinal fluidLower riskInfantsLogistic regressionPatientsHospitalScoresInfectionDaysLow probabilityPhysicians’ and Nurses’ Perspectives on the Decision to Perform Lumbar Punctures on Febrile Infants ≤8 Weeks Old
Aronson PL, Schaeffer P, Fraenkel L, Shapiro ED, Niccolai LM. Physicians’ and Nurses’ Perspectives on the Decision to Perform Lumbar Punctures on Febrile Infants ≤8 Weeks Old. Hospital Pediatrics 2019, 9: 405-414. PMID: 31113814, PMCID: PMC6537124, DOI: 10.1542/hpeds.2019-0002.Peer-Reviewed Original ResearchConceptsFebrile infantsPrimary care pediatriciansLumbar punctureClinical experienceGeneral emergency medicine physiciansEmergency medicine nursesPhysicians' clinical experienceEmergency medicine physiciansAcademic medical centerPhysicians' valuesPhysician assessmentClinical equipoiseMedical CenterMedicine physiciansNurses' perspectivesPhysician usePhysician's decisionInfantsPhysician practicesPhysiciansNursesParents' preferencesPediatriciansConstant comparative methodPuncture
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