Sepsis in children

Background: Sepsis remains lethal to children. At our institution, we have noted that approximately 2% of all hospitalized patients have had sepsis. I n the present study, we analyzed episodes of sepsis that occurred in our wa rd. Methods: Sepsis that occurred in our institution between January 1984 and D ecember 1998 was reviewed and analyzed. Results: Three hundred and sixty-six episodes of sepsis in 244 admitted pat ients were analyzed. Sepsis occurred in approximately 2% of all hospitalize d patients. Forty-three of 244 patients were under 1 year of age. Eighty-se ven percent (212/244) of cases had underlying diseases. Hematologic disorde rs or neoplasms were the most common underlying disease, comprising 55% of all patients (133/244). Two-hundred and fifty-one of 366 episodes of sepsis were acquired during hospitalization. We identified 409 causative agents. There were 25 polymicrobial infections (25/366; 7%). Gram-positive bacteria comprised 68% of all organisms (280/409). Staphylococcus aureus was the mo st common organism, comprising 18% of causing agents (75/409). Sixty-six or ganisms came from the insertion of a central venous catheter. Eighty-one pa tients experienced recurrent episodes of sepsis. In terms of complications, respiratory distress was the most common complication (36 episodes) and th ere were 15 episodes of shock. Thirty-seven patients died of sepsis. Sepsis caused by Gram-negative bacteria showed significantly higher mortality tha n Gram-positive bacteria (11/43 (26%) vs 15/146 (10%); P=0.053). Conclusions: In our institution, approximately 20% of septic patients were under 1 year of age and 90% had underlying diseases. The causative agents o f sepsis affected the outcome.