title: Etiology and prognostic factors of sepsis among children and adolescents admitted to the intensive care unit.
abstract: OBJECTIVE
  To determine the etiology and clinical disease progression variables of sepsis associated with the prognosis of patients admitted to a pediatric intensive care unit.
  
  
  METHODS
  Prospective and retrospective case series. Data were collected from the medical records of patients diagnosed with sepsis who were admitted to the pediatric intensive care unit of a general hospital from January 2011 to December 2013. Bacteria were identified in blood and fluid cultures. Age, sex, vaccination schedule, comorbidities, prior antibiotic use, clinical data on admission, and complications during disease progression were compared in the survival and death groups at a 5% significance level.
  
  
  RESULTS
  A total of 115 patients, with a mean age of 30.5 months, were included in the study. Bacterial etiology was identified in 40 patients. Altered peripheral perfusion on admission and diagnosis of severe sepsis were associated with complications. A greater number of complications occurred in the group of patients older than 36 months (p = 0.003; odds ratio = 4.94). The presence of complications during hospitalization was associated with death (odds ratio = 27.7). The main etiological agents were Gram-negative bacteria (15/40), Staphylococcus aureus (11/40) and Neisseria meningitidis (5/40).
  
  
  CONCLUSIONS
  Gram-negative bacteria and Staphylococcus aureus predominated in the etiology of sepsis among children and adolescents admitted to an intensive care unit. The severity of sepsis and the presence of altered peripheral perfusion on admission were associated with complications. Moreover, the presence of complications was a factor associated with death.
authors.affiliation: Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, BR.
authors.forename: Taís da Costa São
authors.initials: Tda C
authors.lastname: Pedro
authors.affiliation: Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, BR.
authors.forename: André Moreno
authors.initials: AM
authors.lastname: Morcillo
authors.affiliation: Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, BR.
authors.forename: Emílio Carlos Elias
authors.initials: EC
authors.lastname: Baracat
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D009345:Neisseria meningitidis / Q000302:isolation & purification; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D018805:Sepsis / Q000382:microbiology / Q000401:mortality / Q000503:physiopathology*; D012720:Severity of Illness Index; D013211:Staphylococcus aureus / Q000302:isolation & purification*