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. In the present study, we analyzed episodes of sepsis that occurred in our ward.


METHODS
Sepsis that occurred in our institution between January 1984 and December 1998 was reviewed and analyzed.


RESULTS
Three hundred and sixty-six episodes of sepsis in 244 admitted patients were analyzed. Sepsis occurred in approximately 2% of all hospitalized patients. Forty-three of 244 patients were under 1 year of age. Eighty-seven percent (212/244) of cases had underlying diseases. Hematologic disorders 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 most common organism, comprising 18% of causing agents (75/409). Sixty-six organisms came from the insertion of a central venous catheter. Eighty-one patients experienced recurrent episodes of sepsis. In terms of complications, respiratory distress was the most common complication (36 episodes) and there were 15 episodes of shock. Thirty-seven patients died of sepsis. Sepsis caused by Gram-negative bacteria showed significantly higher mortality than 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 of sepsis affected the outcome.
Oda
K
K
Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan. tsumura@ha.bekkoame.ne.jp
Matsuo
Y
Y
Nagai
K
K
Tsumura
N
N
Sakata
Y
Y
Kato
H
H
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D013203:Staphylococcal Infections / Q000382:microbiology / Q000401:mortality; D013211:Staphylococcus aureus / Q000302:isolation & purification
D000900:Anti-Bacterial Agents