Incidence of Serious Infections in Neonatal Hypothermia

Background To date, there is limited information from prior studies to assess the incidence of serious bacterial infection and viral infections in neonates (<30 days) with body temperatures less than 36 degrees Celsius presenting to the Emergency Department. Purpose The purpose of this retrospective review is to analyze cases of neonates presenting with hypothermia to determine the incidence of infections. 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 infections were recorded and analyzed. Results Of the 138 subjects admitted, the 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 for bacterial pathogens (95% confidence interval (CI) 0-2.3%), one was positive for enterovirus (95% CI 0-4.2%). Of the 138 blood cultures, one was positive for 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%). Two surface cultures were positive for Herpes Simplex Virus (85% CI 0.2-5%). In total, there were four serious infections (3%, 95% CI 1-7%). Conclusions In neonates who present to the ED for temperatures <36 degrees Celsius, the incidence of serious infections is very low.