Pediatric infection and sepsis in five age subgroups: single-center registry

Abstract

Summary Background Sepsis is, worldwide, one of the leading causes of death among infants and children. Over the past two decades, mortality rates have declined due to advanced treatment options; however, the incidence of sepsis and septic shock is still on the rise in many hospital settings. The objective of this study was to evaluate the course of this disease in pediatric intensive care patients. Methods An evaluation of pediatric patients in the intensive care unit diagnosed with infections or sepsis between 2005 and 2015 was performed via a retrospective exploratory data analysis. Results During the observational period, 201 patients were diagnosed with infection or sepsis. The study population was divided into five age subgroups. The majority of patients were newborns, infants, and toddlers. Forty percent had sepsis; 6% had septic shock. Viral infection was the most prevalent (59%). The overall survival rate was 83%; newborns and adolescents had the lowest survival rates. Conclusion With this registry, children divided into five age subgroups with infection or sepsis were evaluated and treatment strategies were examined. We have shown that our findings on children treated in our pediatric intensive care unit conform with current literature about pediatric sepsis. In addition to maintaining strict hygiene standards, optimal aspects of sepsis care should be stringently observed, such as the quick administration of empirical broad-spectrum antibiotics, initial adequate fluid resuscitation, and a reliable and frequent routine of source control.

Multiple Electrolytes Solution Versus Saline as Bolus Fluid for Resuscitation in Pediatric Septic Shock: A Multicenter Randomized Clinical Trial*

“…The incidence of AKI varies across different age categories and some have reported age to be an independent determinant of AKI. Any factors which increase the risk of renal injury may therefore manifest differently across different age groups (25)(26)(27). The effect of treatment on the primary outcome was therefore also explored for different age groups (0 to <5 yr, 5 to <10 yr, and 10 to 15 yr).…”

Características clínicas de pacientes con sepsis en una unidad de cuidados intensivos pediátricos de un hospital de segundo nivel.

“…Las Guías de manejo de la sepsis en su adecuación pediátrica, muestran la distribución por estadio, usada en este estudio (22). Nwankwor y otros, muestran, al igual que este trabajo, predominio de la sepsis, con 553 casos (23), al igual que Hermon y otros, predominando las infecciones y la sepsis (24).…”

“…Según Hermon y otros, en su publicación muestran solo un 7 % de progresión hacia el SDMO, con un 40 % de sepsis grave y 6 % de choque séptico (24). La aparición del SDMO en el niño ocurre simultáneamente y a partir de las primeras 24-48 horas, evolucionando en 72 horas a varios sistemas en fallo (10).…”

Association of Sex and Age with Mortality and Health-Related Quality of Life in Children with Septic Shock: A Secondary Analysis of the Life After Pediatric Sepsis Evaluation

“…13 The NIH has made the consideration of sex as a biological variable in research design, analysis, and reporting a research priority. 14 We performed this secondary analysis of the LAPSE cohort to evaluate for sex-based differences in the clinical course and outcomes of community-acquired septic shock in children of different age groups. Our primary hypothesis was that male children would have an increased risk of persistent decline in HRQL or mortality compared to female children and that this effect would differ by age group, with the highest risk in male infants and adolescents.…”

“…[4][5][6][7][8][9][10] In children, sex differences in sepsis susceptibility have been shown to be age-dependent. [11][12][13][14] Infant and adolescent males have an increased risk of mortality in some studies with no difference in prepubertal children. 11,15 It is not clear whether male children have an increased risk of adverse outcomes, including mortality or persistent decline in healthrelated quality of life (HRQL), after community-acquired septic shock, or if age plays a role in differential susceptibility to adverse outcomes.…”