APPLICATION OF NEW SEPSIS DEFINITIONS TO EVALUATE OUTCOME OF PEDIATRIC-PATIENTS WITH SEVERE SYSTEMIC INFECTIONS

No published reports have stratified pediatric patients with systemic infections according to the new sepsis terminology guidelines. In addi tion little is known about the outcome of sepsis in developing countri es. This large 12-year retrospective study evaluated the outcome of 81 5 infants and children with sepsis managed in a Latin American pediatr ic intensive care unit. Of these children 171 (21%) had sepsis, 497 (6 1%) had severe sepsis and 147 (18%) had septic shock, Multiorgan dysfu nction was present in 120 (24%) and 77 (52%) patients with severe seps is and septic shock, respectively. Infection was bacteriologically pro ved in 212 (26%) cases, with Staphylococcus aureus and Neisseria menin gitidis being the most frequent responsible organisms. Three hundred n ineteen (39%) patients died. Case-fatality rates were higher in patien ts with septic shock, multiorgan dysfunction, sepsis caused by Pseudom onas aeruginosa and meningococcemia than in those without these condit ions. Although no difference in mortality was detected between culture -proved and culture-negative sepsis, more patients receiving an inappr opriate antimicrobial agent died than those treated with an appropriat e drug (53% vs, 34%, P = 0.012). We believe that with the use of the n ew terminology system a more reliable comparison of data from pediatri c sepsis studies and of emerging immunomodulating therapeutic modaliti es can be achieved.