Ill Appearance at Examination and Time to Positive Culture

Investigators from multiple institutions conducted a secondary analysis of a cross-sectional study of infants with invasive bacterial infection (IBI) to explore whether time to pathogen detection differed by the infant’s appearance at physical examination. Infants ≤60 days of age who had an ED visit at 1 of 10 participating hospitals and had a blood and/or cerebrospinal fluid (CSF) culture result positive for a noncontaminant pathogen were included. Investigators reviewed the medical records of all eligible infants to extract bacterial blood and CSF culture results, as well as patient demographics and clinical characteristics.

The primary exposure was ill appearance at clinical examination at ED presentation, defined as documentation in the physical examination of any of the following: ill appearing, toxic, limp, unresponsive, gray, cyanotic, apnea, weak cry, poorly perfused, grunting, listless, lethargic, …