Epidemiology and treatment of sepsis at a public pediatric emergency department

Abstract

Objective: To describe the clinical characteristics and treatment of children with sepsis, severe sepsis, and septic shock at a pediatric emergency department of a public hospital. Methods: A retrospective, observational study. The medical records of patients included in the hospital Pediatric Sepsis Protocol and patients with discharge ICD-10 A41.9 (sepsis, unspecified), R57 (shock) and A39 (meningococcal meningitis) were evaluated. Results: A total of 399 patients were included. The prevalence of sepsis, severe sepsis, and septic shock at the emergency room were 0.41%, 0.14% and 0.014%, respectively. The median age was 21.5 months for sepsis, 12 months for severe sepsis, and 20.5 months for septic shock. Sepsis, severe sepsis, and septic shock were more often associated with respiratory diseases. The Respiratory Syncytial Virus was the most common agent. The median time to antibiotic and fluid administration was 3 hours in patients with sepsis and severe sepsis. In patients with septic shock, the median times to administer antibiotics, fluid and vasoactive drugs were 2 hours, 2.5 hours and 6 hours, respectively. The median length of hospital stay for patients with sepsis, severe sepsis and septic shock were 3 days, 4 days and 1 day, respectively. The overall mortality was 2%. Conclusion: Sepsis had a low prevalence. Early diagnosis and recognition are a challenge for the emergency care pediatrician, the first place of admission.

Unusually isolated Staphylococcus arlettae in intra-oral sutures - Case series

“…It is apparent that S. arlettae has a predilection for foreign material surfaces, even though the specific virulence factors of the bacterium are not as well established as they are in Staphylococcus aureus [11]. The literature for its occurrence in human samples is sparse, from being considered as normal skin commensals to being associated with different types of infections especially where a large number of antibiotics have been used [2,3,[12][13][14]. This makes its role in surgical site infections questionable.…”

The association and prognostic value of systemic inflammatory response index with short and long-term mortality in patients with sepsis

“…Sepsis is a common disease in an intensive care unit (ICU), which is a clinical syndrome resulting from an excessive immune response of the body to infection. [1,2] Annually, there are 31.5 million cases of sepsis, and 19.4 million cases of severe sepsis, resulting in a death toll as high as 5.3 million every year. [3] Sepsis is one of the leading causes of in-hospital death in the ICU, with a short-term mortality rate ranging from 30% to 50%, [1] which imposes a heavy burden on families and society.…”