title: Factor influencing case-fatality rate of septicemic children.
abstract: One hundred and fourty episodes of septicemic children seen at Songklanagarind Hospital during a period of two years were reviewed to determine factors related to mortality. One hundred episodes (70.4%) of septicemia were hospital-acquired in which 98 (69%) were caused by gram negative bacilli, with Pseudomonas being the most common agent. Thirty episodes were from gram-positive cocci and eight were from polymicrobial infections. The remainder were caused by Candida species. The overall case-fatality rate was 28.6%. Using a logistic regression model, appropriateness of antibiotic use and host status (being newborn or a compromised host compared to a normal host), but not neutropenia and acquisition of infection were the only statistically significant risk factors. The exact odds ratio of inappropriate use of antibiotic adjusted for host status was 13.6 (95% confidence limits = 5.7-32.3). Percentages of inappropriate usage among the premature and full term newborn, compromised host and normal were 50, 11, 28 and 24, respectively. Inappropriate antibiotic use was the major cause of case-fatality in the study population. It was more common among the premature newborn and compromised hosts.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai Songkhla, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Pruekprasert
authors.forename: V
authors.initials: V
authors.lastname: Chongsuvivatwong
authors.forename: P
authors.initials: P
authors.lastname: Patamasucon
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000401:mortality; D003428:Cross Infection / Q000188:drug therapy / Q000401:mortality*; D003906:Developing Countries; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008826:Microbial Sensitivity Tests; D016017:Odds Ratio; D009894:Opportunistic Infections / Q000188:drug therapy / Q000401:mortality; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000401:mortality; D018805:Sepsis / Q000188:drug therapy / Q000401:mortality*; D016019:Survival Analysis
chemical_list: D000900:Anti-Bacterial Agents