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Volume 17 Supplement 4

Sepsis 2013

  • Poster presentation
  • Open Access

Clinical manifestations, etiology and outcome of sepsis in pediatric patients admitted to the ICU

  • 1,
  • 1 and
  • 1
Critical Care201317 (Suppl 4) :P18

https://doi.org/10.1186/cc12918

  • Published:

Keywords

  • Mechanical Ventilation
  • Clinical Manifestation
  • Staphylococcus Aureus
  • Retrospective Cohort Study
  • Streptococcus Pneumoniae

Background

Sepsis still represents the leading cause of mortality among children and its etiology changes according to age, immune status and geographic location [14]. Prevention of this disease has key role in reducing morbidity and mortality and includes development and application of vaccines [57]. In 2010, pneumococcal and meningococcal C vaccines were introduced in the basic immunization schedule in Brazil. The application of these may already be influencing the etiologic profile of sepsis in childhood [7]. The evaluation of this profile, as well as the clinical manifestations and course of sepsis in the post vaccine, becomes essential for better clinical decision and effective therapeutic approach in hospitalized patients. The objective was to determine clinical manifestations, etiology and outcome of sepsis in patients admitted to a pediatric ICU.

Materials and methods

A retrospective cohort study, by collecting data from medical records of patients diagnosed with sepsis admitted to the pediatric ICU of Hospital Municipal Dr. Mario Gatti, Campinas, SP, from January 2011 to December 2012. The variables studied were: age, sex, vaccination schedule, etiologic agent identified in cultures and clinical outcome.

Results

Eighty-seven patients were included in the study (56 male, 31 female) with a mean hospital stay of 8.16 days, vasoactive drug use of 2.82 days and 5.33 days of mechanical ventilation. In total, 57/87 cultures were negative. Among the positive, the majority (21/30) was collected less than 48 hours after admission and the most frequent etiologies were: Gram-negative bacteria (10), Staphylococcus aureus (7) and Neisseria meningitidis (4). Two cultures were positive for Streptococus pyogenes and only one for Streptococcus pneumoniae. Twenty-four (16.1%) patients died. Mortality was higher in patients with incomplete immunization (P = 0.047). Among the cases with meningococcal etiology, 3/4 were not vaccinated.

Conclusions

The clinical group of patients diagnosed with sepsis showed short time of hospitalization, use of vasoactive drugs and mechanical ventilation. Mortality was high and higher in the group of patients with incomplete immunization. Among the causative agents, it was predominantly Gram-negative bacteria and S. aureus, no vaccine-preventable etiologies.

Authors’ Affiliations

(1)
Department of Pediatrics, State University of Campinas, UNICAMP, Campinas, SP, Brazil

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Copyright

© Pedro et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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