2025
Timing of repeat epinephrine to inform paediatric anaphylaxis observation periods: a retrospective cohort study
Dribin T, Sampson H, Zhang Y, Boyd S, Zhang N, Michelson K, Neuman M, Brousseau D, Mistry R, Freedman S, Aronson P, Bergmann K, Boswell B, Chinta S, Chua W, Cohen A, Cohen J, Daggett A, Davis J, Freeman J, Khanna K, Knoles C, Kwan K, Larsen C, Lee J, Lubell T, Metcalf A, Moake M, Nesiama J, Ngo T, Pulcini C, Russo C, Singh N, Srivastava G, Strutt J, Thapar V, Vander Wyst C, Walsh P, Wolnerman Y, Schnadower D, Academy of Pediatrics P, Kanngiesser A, McGarghan F, Dulchavsky A, Costalez J, DesPain A, Armanious M, Haghnazarian E, Brown-Whitehorn T, Weigert R, Dayan P, Meltzer J, Chowdhury N, Benedetti J, Sinziana C, Handorf A, Ruthford M, Devens M, Mecham C, Holland J, Casas T, Brown J, Panda P, Morrow A, Maready M, Nathani Y, Stevens M, Abraham G, Yen K, Cooper-Sood J, Woolf S. Timing of repeat epinephrine to inform paediatric anaphylaxis observation periods: a retrospective cohort study. The Lancet Child & Adolescent Health 2025, 9: 484-496. PMID: 40506197, DOI: 10.1016/s2352-4642(25)00139-7.Peer-Reviewed Original ResearchConceptsElectronic medical recordsEmergency departmentRetrospective cohort studyCohort studyMedical recordsDocumentation of symptomsCardiovascular involvementHealth-care facilitiesEpinephrine doseAcute allergic reactionsNational Institutes of HealthCumulative incidenceNational Center for Advancing Translational SciencesInstitutes of HealthChildren aged 6 monthsClinical ModificationHospital wardsIncidence rateICD-10Observation periodPrimary outcomeAllergic reactionsSecondary to medicationsInitiation to discontinuationKaplan-Meier analysisRisk Factors for Serious Bacterial Infections Among Young Infants With Hypothermia: Protocol for a Multicenter, Retrospective Case-Control Study
Ramgopal S, Aronson P, Lorenz D, Rogers A, Cruz A. Risk Factors for Serious Bacterial Infections Among Young Infants With Hypothermia: Protocol for a Multicenter, Retrospective Case-Control Study. JMIR Research Protocols 2025, 14: e66722. PMID: 40536806, DOI: 10.2196/66722.Peer-Reviewed Original ResearchConceptsEpidemiology of SBIHerpes simplex virusCase-control studyEmergency departmentYoung infantsMultivariable prediction modelRetrospective nested case-control studyBacterial infectionsRetrospective case-control studyManagement of young infantsNested case-control studyUrinary tract infectionOptimal cutoff valueSerious bacterial infectionsSoft tissue infectionsOutcome measuresPediatric Emergency Medicine Collaborative Research CommitteeReceiver operating characteristic curvePediatric emergency departmentOperating characteristics curveUS children's hospitalsMixed effects logistic regressionHSV-positiveBlood culturesPredicting SBIRisk 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, 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 6Â 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
Disparities in Guideline Adherence for Febrile Infants in a National Quality Improvement Project.
McDaniel C, Truschel L, Kerns E, Polanco Y, Liang D, Gutman C, Cunningham S, Rooholamini S, Thull-Freedman J, Jennings B, Magee S, Aronson P. Disparities in Guideline Adherence for Febrile Infants in a National Quality Improvement Project. 2024, 154 PMID: 39155728, PMCID: PMC11350103, DOI: 10.1542/peds.2024-065922.Peer-Reviewed Original ResearchConceptsQuality improvementDelivery of evidence-based careStandard careEmergency departmentNational quality improvement projectNon-Hispanic black infantsEvidence-based careQuality improvement projectDocumentation of follow-upAssociation of raceNon-Hispanic white infantsClinical practice guidelinesCross-sectional studyPediatrics clinical practice guidelineQI collaborativeEquitable deliveryGuideline implementationFollow-upEthnic disparitiesGuideline adherenceGuideline-concordantIntervention periodAmerican Academy of Pediatrics clinical practice guidelineImprovement projectPractice guidelinesDisposition 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 fluidFebrile infants aged ≤60 days: evaluation and management in the emergency department.
Palladino L, Woll C, Aronson P. Febrile infants aged ≤60 days: evaluation and management in the emergency department. Pediatric Emergency Medicine Practice 2024, 21: 1-28. PMID: 38266065.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsBacterial infectionsManagement of febrile young infantsAmerican Academy of Pediatrics clinical practice guidelineYoung infantsFebrile young infantsPediatrics clinical practice guidelineEmergency departmentUrinary tract infectionRisk stratification toolPositive viral testClinical practice guidelinesTract infectionsViral testingEmergency cliniciansSevere outcomesAmerican AcademyInfectionPractice guidelinesInfantsDepartmentFeverEmergency
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 infectionsCliniciansAgeEffect Modifiers of the Association of High-Flow Nasal Cannula and Bronchiolitis Length of Stay.
Winer J, Richardson T, Berg K, Berry J, Chang P, Etinger V, Hall M, Kim G, Meneses Paz J, Treasure J, Aronson P. Effect Modifiers of the Association of High-Flow Nasal Cannula and Bronchiolitis Length of Stay. Hospital Pediatrics 2023, 13: 1018-1027. PMID: 37795554, PMCID: PMC10593863, DOI: 10.1542/hpeds.2023-007295.Peer-Reviewed Original ResearchConceptsEffect of HFNCICU servicesEffect modifiersHigh-flow nasal cannula therapyMulticenter retrospective cohort studyPediatric Health Information SystemAge groupsHigh-flow nasal cannulaNon-ICU patientsRetrospective cohort studyComplex chronic conditionsMultivariable Poisson regressionFuture prospective studiesPotential effect modifiersInitial desaturationInitial tachypneaCohort studyClinical factorsNasal cannulaHospital recordsProspective studyHospitalized childrenChronic conditionsHFNCPatientsPrevalence 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 infections
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
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
2018
Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture
Aronson PL, Wang ME, Shapiro ED, Shah SS, DePorre AG, McCulloh RJ, Pruitt CM, Desai S, Nigrovic LE, Marble RD, Leazer RC, Rooholamini SN, Sartori LF, Balamuth F, Woll C, Neuman MI. Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture. 2018, 142: e20181879. PMID: 30425130, PMCID: PMC6317769, DOI: 10.1542/peds.2018-1879.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsPhiladelphia criteriaFebrile infantsBacterial meningitisRisk stratificationCSF testingRochester criteriaEmergency departmentLower riskRoutine CSF testingCerebrospinal fluid testingComplex chronic conditionsRoutine lumbar punctureCase-control studyDate of visitLow-risk infantsLumbar punctureChronic conditionsHigh riskInfantsBacterial infectionsDay oldsFluid testingMeningitisRiskFactors Associated with Adverse Outcomes among Febrile Young Infants with Invasive Bacterial Infections
Pruitt CM, Neuman MI, Shah SS, Shabanova V, Woll C, Wang ME, Alpern ER, Williams DJ, Sartori L, Desai S, Leazer RC, Marble RD, McCulloh RJ, DePorre AG, Rooholamini SN, Lumb CE, Balamuth F, Shin S, Aronson PL, Collaborative F, Nigrovic L, Browning W, Mitchell C, Peaper D, Feldman E. Factors Associated with Adverse Outcomes among Febrile Young Infants with Invasive Bacterial Infections. The Journal Of Pediatrics 2018, 204: 177-182.e1. PMID: 30297292, PMCID: PMC6309646, DOI: 10.1016/j.jpeds.2018.08.066.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsFebrile young infantsAdverse outcomesBacterial meningitisYoung infantsIll appearanceFebrile infantsBacterial infectionsRetrospective cohort studyMedical record reviewLocal microbiology laboratoryMixed-effects logistic regressionElectronic medical record systemDays of ageIll appearingNeurologic sequelaeCohort studyMedical record systemClinical factorsMedication receiptMechanical ventilationRecord reviewClinical dataInclusion criteriaMeningitisTime to Pathogen Detection for Non-ill Versus Ill-Appearing Infants ≤60 Days Old With Bacteremia and Meningitis
Aronson PL, Wang ME, Nigrovic LE, Shah SS, Desai S, Pruitt CM, Balamuth F, Sartori L, Marble RD, Rooholamini SN, Leazer RC, Woll C, DePorre AG, Neuman MI. Time to Pathogen Detection for Non-ill Versus Ill-Appearing Infants ≤60 Days Old With Bacteremia and Meningitis. Hospital Pediatrics 2018, 8: 379-384. PMID: 29954839, PMCID: PMC6145376, DOI: 10.1542/hpeds.2018-0002.Peer-Reviewed Original ResearchConceptsBacterial meningitisCerebrospinal fluidOverall low prevalenceIll appearanceChildren's HospitalClinical appearanceEmergency departmentBlood culturesMedical recordsBacteremiaLow prevalenceMeningitisInfantsDay oldsMicrobiology laboratoryDemographic characteristicsBloodPathogen detectionHospitalBacterial pathogensHoursLower proportionDaysPathogensInfectionEpidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments
Woll C, Neuman MI, Pruitt CM, Wang ME, Shapiro ED, Shah SS, McCulloh RJ, Nigrovic LE, Desai S, DePorre AG, Leazer RC, Marble RD, Balamuth F, Feldman EA, Sartori LF, Browning WL, Aronson PL, Collaborative F, Alpern E, Hayes K, Lee B, Lumb C, Mitchell C, Peaper D, Rooholamini S, Shin S, Williams D. Epidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments. The Journal Of Pediatrics 2018, 200: 210-217.e1. PMID: 29784512, PMCID: PMC6109608, DOI: 10.1016/j.jpeds.2018.04.033.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsThird-generation cephalosporinsMicrobiology laboratory databaseEmergency departmentBacterial infectionsBacterial meningitisPediatric emergency departmentCombination of ampicillinAntimicrobial treatment regimenCross-sectional studyGroup B streptococciElectronic medical record systemEmpiric treatmentMedical record systemTreatment regimenChildren's HospitalMost infantsMedical recordsB streptococciCerebrospinal fluidCommon pathogensInfantsAntimicrobial susceptibilityDay oldsInfection
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