Considerations for Special Patient Populations

Neonatal, pediatric, and geriatric patients present unique characteristics which must be considered when diagnosing severe bacterial infections. For example:

• In neonates, PCT shows a physiological elevation in newborns right after birth. Therefore, newborns during their first 3 days of life have different PCT reference values than adults.

• Fever is one of the most common reasons for emergency department and outpatient clinic visits by infants; many of which have no diagnostically reliable signs and symptoms and receive a diagnosis of fever without a source (FWS) after initial clinical evaluation. The majority of patients will be suffering from mild, clinically irrelevant viral infections. However, in some of these patients a serious bacterial infection (SBI) is the underlying cause for fever. Early identification and treatment of patients with SBI is deemed essential to assuring favorable disease outcomes. 

• Among elderly patients, incidence of sepsis is much higher than in younger adults due to co-existing co-morbidities, repeated and prolonged hospitalizations, reduced immunity, functional limitations and frailty. Moreover, the initial clinical picture may be ambiguous and impaired cognitive function, along with confusion and disorientation, can result in patients having difficulty describing their symptoms.  

While it’s important to understand what infection looks like among patients at different life stages, age can’t be the only consideration when assessing infection; the patient’s overall physical status must also be taken into account.¹ With a comprehensive view of their patients’ age and condition, clinicians can diagnose more quickly and accurately while helping prevent escalations to secondary infections such as pneumonia and even sepsis.