Epidemiology of sepsis in pediatrics: first Colombian multicenter pilot survey

Abstract

Objectives: To describe the socio-demographic and clinical features of the patients with diagnosis of sepsis attended in the participant Pediatric Intensive Care Units (PICUs). Methods: We conducted an observational trial in 19 PICUs across the country. An electronic formulary, posted on the website www.sepsisencolombia.com, was used to collect the epidemiological features of children with sepsis. We used the STATA(registered trademark) software version 10. Frequencies and proportions were calculated. Results: 1029 patients were included in this study, which lasted twelve months (from March 2009 to February 2010). We found that 55,2% of the cases were male (relation 1,2:1), 56% were less than two years old, 69.7% came from urban areas, and 30,3% came from rural villages. 76.6% were very poor (SCORE 1 and 2 over 6 Colombian socioeconomic classifications) and 43.2% have government supported insurance. 27.3% of the population presented with sepsis, 24.7% with severe sepsis and 48% with septic shock. Respiratory (54.5%) and abdominal (18%) infections were the most common causes of the sepsis. In 51.3% no microbial agent was identified. 67.7% required mechanical ventilation. The mortality rate was 18.2%. Conclusion: Pediatric sepsis is a common diagnosis in Colombian PICUs. It affects principally children under 2 years and with low socioeconomic status. It is slightly more common in males. In most cases, respiratory tract infections were the origin of the disease. We did not find the microbial origin in more than half of the children. The disease has an important mortality (average 1 death/month/unit) and high costs for our society.