Predictors of serious bacterial infection in infants up to 8 weeks of age.

During a period of 2 years we prospectively studied 116 infants up to 8 weeks of age with suspected sepsis. Each infant was assessed clinically before laboratory evaluation for sepsis. Depending upon impression of sepsis, temperature abnormality, micro ESR (mESR), WBC counts and toxic granulations infants were assigned to either high (n = 74) or low (n = 31) risk group for serious bacterial infection (SBI). All infants were kept under observation till the final decision for hospitalization was made. Eighty six per cent of cases in high risk group and 26% of cases in low risk group were hospitalized and treated with antibiotics. SBI was present in 55% of the high risk group infants compared to one (3%) in the low risk group. Culture for bacterial infections were positive in 22 (19%) cases; bacteremia was found in 15 (13%) infants. None of the variables individually predicted the presence of bacteremia or SBI satisfactorily. Presence of two or more criteria out of the three criteria namely impression of sepsis, raised mESR and toxic granulation could identify 93% of infants with bacteremia and 95% of those with SBI and excluded 89% of cases without SBI.