APPLICATION OF NEW SEPSIS DEFINITIONS TO EVALUATE OUTCOME OF PEDIATRIC-PATIENTS WITH SEVERE SYSTEMIC INFECTIONS
APPLICATION OF NEW SEPSIS DEFINITIONS TO EVALUATE OUTCOME OF PEDIATRIC-PATIENTS WITH SEVERE SYSTEMIC INFECTIONS
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DOI：
10.1097/00006454-199507000-00001
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发表时间：
1995-07-01
影响因子：
3.6
通讯作者：
CORONADO, L
中科院分区：
文献类型：
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作者：
SAEZLLORENS, X;VARGAS, S;CORONADO, L
没有发表的报告根据新的脓毒症术语指南对全身感染的儿科患者进行分层。此外，对发展中国家脓毒症的结局知之甚少。这项大型的12年回顾性研究评估了在拉丁美洲儿科重症监护病房治疗的815名败血症婴儿和儿童的结局。其中171例（21%）为脓毒症，497例（61%）为严重脓毒症，147例（18%）为感染性休克。严重脓毒症和感染性休克患者分别有120例（24%）和77例（52%）出现多器官功能障碍。212例（26%）经细菌学证实感染，金黄色葡萄球菌和脑膜炎奈瑟菌是最常见的致病菌。39%的患者死亡。感染性休克、多器官功能障碍、铜绿假单胞菌引起的脓毒症和脑膜炎双球菌血症患者的病死率高于无这些疾病的患者。虽然在细菌培养证实和细菌培养阴性的脓毒症之间没有检测到死亡率的差异，但接受不适当的抗菌药物治疗的患者死亡率高于接受适当药物治疗的患者（53% vs 34%，P = 0.012）。我们相信，通过使用新的术语系统，可以更可靠地比较儿科脓毒症研究和新兴免疫调节治疗方式的数据。
No published reports have stratified pediatric patients with systemic infections according to the new sepsis terminology guidelines. In addition little is known about the outcome of sepsis in developing countries. This large 12-year retrospective study evaluated the outcome of 815 infants and children with sepsis managed in a Latin American pediatric intensive care unit. Of these children 171 (21%) had sepsis, 497 (61%) had severe sepsis and 147 (18%) had septic shock, Multiorgan dysfunction was present in 120 (24%) and 77 (52%) patients with severe sepsis and septic shock, respectively. Infection was bacteriologically proved in 212 (26%) cases, with Staphylococcus aureus and Neisseria meningitidis being the most frequent responsible organisms. Three hundred nineteen (39%) patients died. Case-fatality rates were higher in patients with septic shock, multiorgan dysfunction, sepsis caused by Pseudomonas aeruginosa and meningococcemia than in those without these conditions. Although no difference in mortality was detected between culture-proved and culture-negative sepsis, more patients receiving an inappropriate antimicrobial agent died than those treated with an appropriate drug (53% vs, 34%, P = 0.012). We believe that with the use of the new terminology system a more reliable comparison of data from pediatric sepsis studies and of emerging immunomodulating therapeutic modalities can be achieved.