2024
Disposition 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-centeredFebrile 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 guidelinesInfantsDepartmentFeverEmergencyContaminant 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, 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. Pediatrics 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. Pediatrics 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 regressionPrevalence
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. Pediatrics 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. Pediatrics 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 testingMeningitisRiskTime 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
2017
Impact of Enteroviral Polymerase Chain Reaction Testing on Length of Stay for Infants 60 Days Old or Younger
Aronson PL, Lyons TW, Cruz AT, Freedman SB, Okada PJ, Fleming AH, Arms JL, Thompson AD, Schmidt SM, Louie J, Alfonzo MJ, Monuteaux MC, Nigrovic LE, Group P, Alpern E, Balamuth F, Bradin S, Curtis S, Garro A, Grether-Jones K, Ishimine P, Kulik D, Mahajan P, Miller A, Mistry R, Pruitt C, Schnadower D, Shah S, Thomson J, Uspal N. Impact of Enteroviral Polymerase Chain Reaction Testing on Length of Stay for Infants 60 Days Old or Younger. The Journal Of Pediatrics 2017, 189: 169-174.e2. PMID: 28705656, PMCID: PMC5870831, DOI: 10.1016/j.jpeds.2017.06.021.Peer-Reviewed Original ResearchConceptsPCR testShorter LOSCentral nervous system infectionPolymerase chain reaction testingCerebrospinal fluid culturesNervous system infectionPlanned secondary analysisLarge multicenter cohortCerebrospinal fluid evaluationLength of stayPositive test resultsNegative test resultsDays of ageHospital lengthHospital LOSRetrospective cohortSystem infectionBacterial meningitisMulticenter cohortPatient ageFluid cultureHospital CenterPCR testingReaction testingInfants