Etiology and prognostic factors of sepsis among children and adolescents admitted to the intensive care unit

Abstract

ObjectiveTo determine the etiology and clinical disease progression variables of sepsis associated with the prognosis of patients admitted to a pediatric intensive care unit.MethodsProspective and retrospective case series. Data were collected from the medical records of patients diagnosed with sepsis who were admitted to the pediatric intensive care unit of a general hospital from January 2011 to December 2013. Bacteria were identified in blood and fluid cultures. Age, sex, vaccination schedule, comorbidities, prior antibiotic use, clinical data on admission, and complications during disease progression were compared in the survival and death groups at a 5% significance level.ResultsA total of 115 patients, with a mean age of 30.5 months, were included in the study. Bacterial etiology was identified in 40 patients. Altered peripheral perfusion on admission and diagnosis of severe sepsis were associated with complications. A greater number of complications occurred in the group of patients older than 36 months (p = 0.003; odds ratio = 4.94). The presence of complications during hospitalization was associated with death (odds ratio = 27.7). The main etiological agents were Gram-negative bacteria (15/40), Staphylococcus aureus (11/40) and Neisseria meningitidis (5/40).ConclusionGram-negative bacteria and Staphylococcus aureus predominated in the etiology of sepsis among children and adolescents admitted to an intensive care unit. The severity of sepsis and the presence of altered peripheral perfusion on admission were associated with complications. Moreover, the presence of complications was a factor associated with death.

The Dynamical Assessment of Inflammatory Biomarkers in Predicting the Outcome of Septic Patients and the Response to Antimicrobial Therapy

“…In our study, the etiology of sepsis was identified in 46.7% of cases, similar to other data published in the medical literature [14,15]. In this context, monitoring the kinetics of inflammatory biomarkers in the first 48-72 hours can be a useful method to assess the outcome of patients with sepsis, the response to antimicrobial therapy and the rates of mortality.…”

Cardiopatias congênitas em crianças e adolescentes: caracterização clínico-epidemiológica em um hospital infantil de Manaus-AM

“…Dependendo do tipo e da complexidade das CC, muitas crianças precisam de correção cirúrgicas, havendo a necessidade de uma atenção a saúde diferenciada, ainda mesmo durante o pré-natal, uma vez que possa ser diagnosticada precocemente logo nos primeiros meses de vida, aumentando desta forma as chances de sobrevida 12,13 . A predominância de internações em crianças e adolescentes do sexo masculino (60%) vai de encontro com os estudos de Huber et al 14 , diferente de Frota et al 4 , Silva et al 15 e Mourato 16 , que assinalam em seus manuscritos maior índice para o sexo feminino.…”

“…Constatou-se nesse estudo que apenas 19% das crianças e adolescentes internados por cardiopatias tinham Síndrome de Down, enquanto que outros estudos identificaram está síndrome em cerca de 40 a 60%, apontando associação com a cardiopatia congênita e mortalidade nos primeiros anos de vida 2,16 . 21 enfatiza que a escolaridade dos pais é um fator importante, visto que o conhecimento facilita a provisão de cuidados aos seus filhos.…”

Sepsis epidemiology and outcome in the paediatric intensive care unit of Vilnius University Children’s Hospital

“…Mortality in paediatric ICUs is not the same in different countries. It may reach values above 50% and varies across geographical regions: 21% in North America, 29% in Europe, 32% in Australia/New Zealand, 40% in Asia, 11% in South America, and 40% in Africa ( 14 , 15 ).…”