Rate of Urinary Tract Infections, Bacteremia, and Meningitis in Preterm and Term Infants

BACKGROUND AND OBJECTIVES There are very limited data on the rate of urinary tract infections (UTI), bacteremia, and meningitis in preterm infants with fever. Many of the studies on the incidence of these infections excluded preterm infants. This study compared the rate of these infections in preterm infants born at 32–36 weeks to term infants born at 37–42 weeks. METHODS A multicenter observational cohort study was conducted to evaluate rates of UTI, bacteremia, and meningitis in term and preterm infants 8–60 days of age with a diagnosis of fever from 2016 through 2022 using encounter data from children’s hospitals in the Pediatric Health Information System. RESULTS There were 19 507 total febrile infants identified, of which 2162 were preterm and 17 345 were term. Preterm infants had a lower rate of UTI than term infants (1.8% confidence interval CI 1.3–2.5 vs 3.0% CI 2.7–3.2, P = .001). Preterm and term infants did not have statistically different rates of bacteremia (1.5% CI 1.3–1.7 vs 1.2% CI 0.8–1.8, P = .44) or meningitis (0.16% CI 0.1–0.2 vs 0.05% CI 0–0.2, P = .36). CONCLUSIONS There was no difference in the rate of bacteremia or meningitis between term and preterm infants in a large multicenter cohort of febrile infants. Preterm infants had a lower rate of UTI than term infants. This is the first multicenter study to compare UTI, bacteremia, and meningitis between term and preterm febrile infants.