Characteristics and Outcomes of Culture-Positive and Culture-Negative Pediatric Sepsis.
Document Type
Article
Publication Date
12-2023
Identifier
DOI: 10.1016/j.jpeds.2023.113718
Abstract
OBJECTIVES: To compare the outcomes of pediatric severe sepsis and septic shock among patients with culture-positive and culture-negative sepsis and to determine if there are differentiating markers of disease severity between these 2 populations during their initial presentation and emergency department (ED) stay.
STUDY DESIGN: Retrospective cohort study of patients ≤21 years of age who presented to the ED of a single children's hospital with severe sepsis or septic shock from June 1, 2017 to June 5, 2019.
RESULTS: There were 235 patients who met criteria for severe sepsis or septic shock. Of these, 139 (59.1%) had culture-negative sepsis and 96 (40.9%) had culture-positive sepsis. In the adjusted multivariable model, children with culture-negative sepsis had more intensive care unit (ICU)-free days than those with culture-positive sepsis (27.3 vs 24.1; adjusted median differences [aMD] -2.6 [-4.4, -0.8]). There were no differences in mortality or hospital-free days. On initial presentation, there were no differences in fever, hypothermia, tachycardia, tachypnea, or hypotension between the 2 groups. There were no differences in proportion of patients receiving the following interventions: intravenous (IV) antibiotics, IV fluids, vasoactive medications, CPR, intubation, or time from arrival to provision of these interventions.
CONCLUSIONS: Culture-negative sepsis constitutes a substantial proportion of pediatric severe sepsis and septic shock. In this study, patients with culture-negative and culture-positive sepsis presented similarly on arrival to the ED and received similar treatments while there. Patients with culture-negative sepsis had more ICU-free days than those with culture-positive sepsis, although differences in hospital length of stay (LOS) and mortality were not observed.
Journal Title
The Journal of pediatrics
Volume
263
First Page
113718
Last Page
113718
MeSH Keywords
Humans; Child; Shock, Septic; Retrospective Studies; Sepsis; Length of Stay; Intensive Care Units; Emergency Service, Hospital; Hospital Mortality
Keywords
Septic Shock; Retrospective Studies; Sepsis; Length of Stay; Intensive Care Units; Hospital Emergency Service; Hospital Mortality
Recommended Citation
Baker AH, Leland SB, Freiman E, Herigon JC, Eisenberg MA. Characteristics and Outcomes of Culture-Positive and Culture-Negative Pediatric Sepsis. J Pediatr. 2023;263:113718. doi:10.1016/j.jpeds.2023.113718
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