Sepsis Syndrome in Children: Can We Do Better?
Sepsis is a significant healthcare problem both in industrialized and developing countries. In the United States the incidence of disease is 56 and 240 per 100,000 per year in children and adults respectively. In adults underlying disease is present in 83%. Approximately 50% of the children have underlying diseases. Annual total costs of sepsis in the United States are estimated at $2 billion in children and $17 billion in adults (Martin et al., 2003; Watson et al., 2003). The major pathogens causing severe sepsis and septic shock are N. meningitidis, S. pneumoniae, Group A α- and β-haemolytic Streptococci, and Staphylococcus aureus. Group B Streptococci play an important role in neonatal sepsis, while Capnocytophaga canimorsus is occasionally reported after dog bites. Before the vaccination era, Haemophilus influenzae was a major cause of sepsis in infants and young children.
KeywordsSeptic Shock Severe Sepsis Meningococcal Disease Sepsis Syndrome Purpura Fulminans
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- Dawson, S.J., Wiman, B., Hamsten, A., Green, F., Humphries, S., and Henney, A.M. (1993). The two allele sequences of a common polymorphism in the promoter of the plasminogen activator inhibitor-1 (PAI-1) gene respond differently to interleukin-1 in HepG2 cells. J. Biol. Chem. 268, 10739–10745.PubMedGoogle Scholar
- De Kleijn, E.D., De Groot, R., Hack, C.E., Mulder, P.G., Engl, W., Moritz, B. et al. (2003). Activation of protein C following infusion of protein C concentrate in children with severe meningococcal sepsis and purpura fulminans: A randomized, double-blinded, placebo-controlled, dose-finding study. Crit. Care. Med. 31, 1839–1847.PubMedCrossRefGoogle Scholar
- Haralambous, E., Hibberd, M., Ninis, N., Hermans, P., Nadel, E., and Levin, M. (2003a). The role of the functional plasminogen-activator-inhibitor-1 4G/5G promoter polymorphism in susceptibility, severity and outcome of meningococcal disease in Caucasian children. Crit. Care. Med. 31(12), 2788–2793.PubMedCrossRefGoogle Scholar
- Kornelisse, R.F., Hazelzet, J.A., Savelkoul, H.F., Hop, W.C., Suur, M.H., Borsboom, A.N. et al. (1996). The relationship between plasminogen activator inhibitor-1 and proinflammatory and counterinflammatory mediators in children with meningococcal septic shock. J. Infect. Dis. 173, 1148–1156.PubMedCrossRefGoogle Scholar
- Levin, M., Quint, P.A., Goldstein, B., Barton, P., Bradley, J.S., Shemie, S.D. et al. (2000). Recombinant bactericidal/permeability-increasing protein (rBPI21) as adjunctive treatment for children with severe meningococcal sepsis: A randomised trial. rBPI21 Meningococcal Sepsis Study Group. Lancet 356, 961–967.PubMedCrossRefGoogle Scholar