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Serious bacterial infection in young infants
In 1975 Teele, Pelton and colleagues reported the results of cultures of blood of 600 consecutive febrile children.1 Their findings – about 10% of infants who had temperatures above 38oC and white counts above 15,000 had bacteraemia, most commonly with Haemophilus influenzae type B or Streptococcus pneumoniae. This landmark study launched a 35-year odyssey that continues to this day – how to identify young infants with serious bacterial infection (SBI). The major changes over the past 15 years have been the dramatic reduction in the incidence of bacterial meningitis and bacteraemia, following the introduction of the H influenzae type B and pneumococcal conjugate vaccines, and the aggressive search for urinary tract infections (UTIs). Interestingly, given numerous recent reports about UTIs, identifying infants with UTIs may not be as important as once thought. In this issue, Olaciregui et al from Spain, report on the diagnostic utility of procalcitonin (PCT)
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