TY - JOUR T1 - Febrile young infants with abnormal urine dipstick at low risk of invasive bacterial infection JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 758 LP - 763 DO - 10.1136/archdischild-2020-320468 VL - 106 IS - 8 AU - Roberto Velasco AU - Ainara Lejarzegi AU - Borja Gomez AU - Mercedes de la Torre AU - Isabel Duran AU - Amaia Camara AU - Daniel de la Rosa AU - Sergio Manzano AU - Jose Rodriguez AU - Andres González AU - Anne-Aurelie Lopes AU - Aristides Rivas AU - Isabel Martinez AU - Carlos Miguel Angelats AU - Sandra Moya AU - Sonia Corral AU - Juan Alonso AU - Patricia del Rio AU - Elena Sancho AU - Ignacio Ruiz del Olmo AU - Inmaculada Nieto AU - Beatriz Vega AU - Santiago Mintegi A2 - , Y1 - 2021/08/01 UR - http://adc.bmj.com/content/106/8/758.abstract N2 - Objectives To develop and validate a prediction rule to identify well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick at low risk of invasive bacterial infections (IBIs, bacteraemia or bacterial meningitis).Design Ambispective, multicentre study.Setting The derivation set in a single paediatric emergency department (ED) between 2003 and 2017. The validation set in 21 European EDs between December 2017 and November 2019.Patients Two sets of well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick (either leucocyte esterase and/or nitrite positive test).Main outcome Prevalence of IBI in low-risk infants according to the RISeuP score.Results We included 662 infants in the derivation set (IBI rate:5.2%). After logistic regression, we developed a score (RISeuP score) including age (≤15 days old), serum procalcitonin (≥0.6 ng/mL) and C reactive protein (≥20 mg/L) as risk factors. The absence of any risk factor had a sensitivity of 96.0% (95% CI 80.5% to 99.3%), a negative predictive value of 99.4% (95% CI 96.4% to 99.9%) and a specificity of 32.9% (95% CI 28.8% to 37.3%) for ruling out an IBI. Applying it in the 449 infants of the validation set (IBI rate 4.9%), sensitivity, negative predictive value and specificity were 100% (95% CI 87.1% to 100%), 100% (95% CI 97.3% to 100%) and 29.7% (95% CI 25.8% to 33.8%), respectively.Conclusion This prediction rule accurately identified well-appearing febrile infants aged ≤90 days with an abnormal urine dipstick at low risk of IBI. This score can be used to guide initial clinical decision-making in these patients, selecting infants suitable for an outpatient management.Data are available upon reasonable request. ER -