An epidemiologic survey of pediatric sepsis in regional hospitals in China

Abstract

Objective: To determine the prevalence, treatment, and outcomes of sepsis at regional hospitals in Huai'an, Jiangsu, China.

Design: Prospective data registry using a descriptive clinical epidemiologic approach through a collaborative network.

Setting: Pediatric departments in 11 regional city and county referral hospitals serving 843,000 children (exclusive of neonates).

Subjects: All admissions (n = 27,836) of patients from 28 days to 15 years old from September 1, 2010, to August 31, 2011.

Interventions: None.

Measurements and main results: A total of 1,530 patients met the 2005 international consensus definition of sepsis, corresponding to an estimated incidence of 181/100,000 children, with 80% under 5 years old, and in 10% (153), severe sepsis or septic shock developed. The overall case fatality rate for sepsis was 3.5% (53/1,530) or 34.6% (53/153) in those in whom severe sepsis or septic shock developed. Treatment varied widely and in many instances did not conform to international guidelines as reflected by inadequate use of antibiotics, corticosteroids, vasoactive agents, and inotropes.

Conclusions: We first report the prevalence and outcome of pediatric sepsis based on a regional hospital network in China. The diverse treatment approaches and practice at low-level clinics suggest the need for clinical implementation of internationally recognized strategy to improve the care standard in resource-limited regional hospitals.