The Infant Study for Cold Exposure

Rondavicen A and Katgana T

Published on: 2023-04-01

Abstract

Objective: To date, there have not been any large studies to assess rates of serious bacterial infection (SBI) and herpes simplex virus (HSV) infection in neonates (<30 days) with body temperatures less than 36 degrees Celsius presenting to the ED. The purpose of this retrospective review is to identify and describe which neonates presenting with hypothermia are at increased risk for serious infectious and non-infectious outcomes.

Methods: We conducted a single-center retrospective review of patients seen from 1/1/2015 through 12/01/2020 with a presenting complaint of hypothermia in the emergency department of an urban, free standing, tertiary care children’s hospital. Subjects were under 30 days of life, born at term, with documented temperatures < 36 degrees Celsius. Serious infectious and non-infectious outcomes were recorded and analyzed.

Results: Of the 138 subjects admitted, duration of hospitalization ranged from 2 to 19 days. There were no deaths in the study cohort. Of the 130 CSF cultures, none were positive (95% confidence interval (CI) 0-2.3%) for bacterial pathogens. Of the 138 blood cultures, one was positive, a presumed contaminant (Staphylococcus epidermidis) (true positivity rate 95% CI 0-2.2%). Of the 138 urine cultures, one was positive (for Group B streptococcus) (1%, 95% CI 0-4%). In total, there were four serious outcomes (3%, 95% CI 1-7%). Of the 138 subjects admitted, 17 had bradypnea or apnea in the ED. Of these, four required endotracheal intubations.

Conclusion: In neonates who present to the ED for temperatures <36 degrees Celsius, serious infectious and non-infectious outcomes are extremely rare.