Oda K, Matsuo Y, Nagai K, Tsumura N, Sakata Y, Kato H
Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.
Pediatr Int. 2000 Oct;42(5):528-33. doi: 10.1046/j.1442-200x.2000.01281.x.
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.
Sepsis that occurred in our institution between January 1984 and December 1998 was reviewed and analyzed.
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).
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.
脓毒症对儿童来说仍然是致命的。在我们机构，我们注意到所有住院患者中约有2%发生过脓毒症。在本研究中，我们分析了在我们病房发生的脓毒症发作情况。
回顾并分析了1984年1月至1998年12月期间在我们机构发生的脓毒症。
分析了244例入院患者的366次脓毒症发作情况。脓毒症发生在所有住院患者的约2%中。244例患者中有43例年龄在1岁以下。87%（212/244）的病例有基础疾病。血液系统疾病或肿瘤是最常见的基础疾病，占所有患者的55%（133/244）。366次脓毒症发作中有251次是在住院期间获得的。我们确定了409种病原体。有25例混合感染（25/366；7%）。革兰氏阳性菌占所有病原体的68%（280/409）。金黄色葡萄球菌是最常见的病原体，占致病因子的18%（75/409）。66种病原体来自中心静脉导管的插入。81例患者经历了脓毒症复发。就并发症而言，呼吸窘迫是最常见的并发症（36次发作），有15次休克发作。37例患者死于脓毒症。革兰氏阴性菌引起的脓毒症死亡率明显高于革兰氏阳性菌（11/43（26%）对15/146（10%）；P = 0.053）。
在我们机构，约20%的脓毒症患者年龄在1岁以下，90%有基础疾病。脓毒症的病原体影响了结局。
