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{
    "pk": 17199,
    "title": "Emergency Department Septic Screening in Respiratory Syncytial Virus (RSV) and Non-RSV Bronchiolitis",
    "subtitle": null,
    "abstract": "Objective: To identify factors associated with culture-proven serious bacterial infection (SBI) and positive emergency department septic screening (EDSS) tests in children with bronchiolitis and to identify factors associated with the performance of EDSS.\n\n\nMethods: We reviewed an existing study database of patients with bronchiolitis. We defined a positive EDSS as urine with ≥10 WBC per high power field or cerebrospinal fluid (CSF) with ≥10 WBC per high power field (>25 WBC in neonates), or if organisms were identified on gram stain. We defined SBI as significant growth of an accepted pathogen in blood, urine or CSF. Our composite endpoint was positive if either of these was positive. The decision to perform testing was modeled using modified Poisson regression; the presence of the combined outcome was modeled using logistic regression modified for rare events.\n\n\nResults: We studied 640 children. Testing was performed in 199/640 (31.1%). These tended to be younger than two months RR 2.69 (95% CI 2.11, 3.44), febrile RR 2.01 (95% CI 1.58, 2.55), more dehydrated RR 1.50 (95% CI 1.28, 1.75) and had more severe chest wall retractions RR 1.54 (95% CI 1.22, 1.94). Only 11/640(1.7%) had a positive EDSS or SBI. Younger age (OR 0.67 per month; 95% CI 0.45, 0.99) and a negative RSV antigen test (OR 6.22; 95% CI 1.30, 29.85) were associated with the composite endpoint.\n\n\nConclusion: Testing was more likely to be performed in children younger than two months of age, and in those who were febrile, dehydrated, and had more severe chest wall retractions. A positive EDSS or SBI was rare occurring in younger infants with non-RSV bronchiolitis.  [West J Emerg Med. 2010; 11(1):60-67].",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "Respiratory Syncytial Virus"
        },
        {
            "word": "Bronchiolitis"
        },
        {
            "word": "bacterial infection"
        },
        {
            "word": "septic screen"
        },
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "Infectious disease"
        }
    ],
    "section": "Article",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3d40f9jp",
    "frozenauthors": [
        {
            "first_name": "Chris",
            "middle_name": "",
            "last_name": "Chee",
            "name_suffix": "",
            "institution": "Kern Medical Center, Department of Emergency Medicine, Bakersfield, CA",
            "department": "None"
        },
        {
            "first_name": "Paul",
            "middle_name": "",
            "last_name": "Walsh",
            "name_suffix": "",
            "institution": "Kern Medical Center and Department of Internal Medicine, University of California, Los Angeles, California, USA",
            "department": "None"
        },
        {
            "first_name": "Sam",
            "middle_name": "",
            "last_name": "Kuan",
            "name_suffix": "",
            "institution": "Kern Medical Center, Department of Emergency Medicine, Bakersfield, CA",
            "department": "None"
        },
        {
            "first_name": "Juanito",
            "middle_name": "",
            "last_name": "Cabangangan",
            "name_suffix": "",
            "institution": "Kern Medical Center, Department of Emergency Medicine, Bakersfield, CA",
            "department": "None"
        },
        {
            "first_name": "Kian",
            "middle_name": "",
            "last_name": "Azimian",
            "name_suffix": "",
            "institution": "Kern Medical Center, Department of Emergency Medicine, Bakersfield, CA",
            "department": "None"
        },
        {
            "first_name": "Christopher",
            "middle_name": "",
            "last_name": "Dong",
            "name_suffix": "",
            "institution": "Kern Medical Center, Department of Emergency Medicine, Bakersfield, CA",
            "department": "None"
        },
        {
            "first_name": "Joshua",
            "middle_name": "",
            "last_name": "Tobias",
            "name_suffix": "",
            "institution": "Kern Medical Center, Department of Emergency Medicine, Bakersfield, CA",
            "department": "None"
        },
        {
            "first_name": "Stephen",
            "middle_name": "J",
            "last_name": "Rothenberg",
            "name_suffix": "",
            "institution": "Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (I.P.N), México",
            "department": "None"
        }
    ],
    "date_submitted": "2009-03-14T07:00:00Z",
    "date_accepted": "2009-03-14T07:00:00Z",
    "date_published": "2010-04-02T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17199/galley/8694/download/"
        }
    ]
}