Toda Naoko, Hoshina Takayuki, Koga Yuhki, Ochiai Masayuki, Kaku Noriyuki, Yamamura Kenichiro, Torisu Hiroyuki, Ihara Kenji, Takada Hidetoshi, Maehara Yoshihiko, Hara Toshiro
Departments of Pediatrics, Graduate School of Medical Sciences, Kyushu University.
Jpn J Infect Dis. 2016 Nov 22;69(6):464-470. doi: 10.7883/yoken.JJID.2015.591. Epub 2016 Feb 19.
In developed countries, the infection related-mortality rates in children hospitalized in tertiary medical facilities, where many patients with underlying disease are also hospitalized, are uncertain. We investigated the characteristics of infectious diseases-related fatal cases in the pediatric ward of a Japanese tertiary medical facility. A total of 188 patients who died in the pediatric ward or intensive care unit at Kyushu University Hospital from 2002 to 2011 were enrolled. The patient characteristics were investigated based on their medical records. A total of 35 patients died of infections, 31 of whom had underlying diseases. Most patients died of sepsis or pneumonia (n = 27). All 9 patients who died within 7 days of birth were premature. Nine of the 13 patients with malignancy or hematological disorders died of hematopoietic stem cell transplantation (HSCT)-associated infections. The ratio of infectious disease-related fatal cases to the total cases decreased in the latter half of the study period. In particular, the proportion of preterm infants who died of infections was significantly lower in the latter 5 years (p = 0.02). Many of the infectious disease-related fatal cases were in premature infants and HSCT or post-HSCT patients. However, the mortality due to infectious diseases decreased in these patient groups.
在发达国家,在三级医疗设施住院的儿童中,感染相关死亡率尚不确定,因为许多患有基础疾病的患者也在这些设施中住院。我们调查了日本一家三级医疗设施儿科病房中与传染病相关的死亡病例特征。纳入了2002年至2011年在九州大学医院儿科病房或重症监护病房死亡的188例患者。根据病历调查患者特征。共有35例患者死于感染,其中31例患有基础疾病。大多数患者死于败血症或肺炎(n = 27)。所有在出生后7天内死亡的9例患者均为早产儿。13例患有恶性肿瘤或血液系统疾病的患者中有9例死于造血干细胞移植(HSCT)相关感染。在研究期后半段,传染病相关死亡病例占总病例的比例下降。特别是,后5年死于感染的早产儿比例显著降低(p = 0.02)。许多与传染病相关的死亡病例发生在早产儿以及HSCT或HSCT后患者中。然而,这些患者群体中因传染病导致的死亡率有所下降。