Article Text

SEPSIS: EPIDEMIOLOGICAL AND CLINICAL ASPECTS
  1. A Balasa1,
  2. V Cuzic1,
  3. C Mihai1,
  4. R Stoicescu2,
  5. L Mihai1,
  6. C Frecus1
  1. 1Department of Pediatrics, Faculty of Medicine, Ovidius University, Constanta, Romania
  2. 2Department of Clinical Microbiology, Faculty of Medicine, Ovidius University, Constanta, Romania

Abstract

Objectives To establish the incidence of sepsis in hospitalised infants, to estimate the relation between age and risk factors, to evaluate the severity of infection and the evolution under therapy.

Material and Methods We evaluated 58 infants with sepsis admitted to the intensive care unit of the Emergency Clinical Hospital in Constanta during a 3-year period (January 2005 to January 2008).

Results The highest number of patients diagnosed with sepsis were in the 0–3 months age group, 76.20% (44 cases) of all septic infections in infants. The incidence of sepsis decreased for infants older than 3 months. The risk factors for infants were represented by: prematurity, respiratory distress and congenital malformations. All patients had invasive procedures performed at birth, such as intravenous catheters, parenteral nutrition, respiratory support. Immunosuppression and protein–calorie malnutrition were risk factors in older infants. Escherichia coli was the most common pathogen in neonates, whereas Staphylococcus aureus and Gram-negative bacilli were the cause of sepsis in infants. Out of a total number of 58 cases with sepsis, 33 patients (56.29%) developed severe sepsis and 25 patients (43.10) developed toxic shock. Sepsis, especially with Gram-negative bacilli, represents a major cause of mortality, particularly in neonates. In our group study there were 19 deaths (32.75%), of which 14 cases (24.13%) occurred in the first month of life.

Conclusions Precocious diagnosis, rapid initiation of appropriate antimicrobial therapy and aggressive volume resuscitation dramatically decreases the mortality and improves the outcome of the patient.

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