Editorial: Sepsis in Neonates and Children

Frontiers in Pediatrics

article

Eric Giannoni¹  Luregn J. Schlapbach² 

[1] Department Mother-Woman-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne;Child Health Research Centre, The University of Queensland;Paediatric Intensive Care Unit, Queensland Children's Hospital;Pediatric and Neonatal Intensive Care Unit, Children‘s Research Center, University Children’s Hospital Zurich and University of Zurich

关键词: neonate;    child;    immune dysregulation;    sepsis;    septic shock;    mortality;    shock;   

DOI  :  10.3389/fped.2020.621663

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Sepsis, defined as life-threatening organ dysfunction resulting from dysregulated host response to infection, affects over 25 million children every year, causing an estimated 3 million deaths in neonates, children and adolescents globally (1). The life-time incidence of sepsis is strongly agedependent, with highest rates observed in preterm neonates, followed by neonates, infants, and children (2). Specific challenges have traditionally hindered progress in the field of sepsis in children (3). Albeit epidemiology is often split into neonatal and pediatric age groups, the evidence to support the traditional 1-month-of-age cut-off stands on shaky grounds. Sepsis in very preterm neonates exposed to multiple iatrogenic risks likely represents a very distinct disease from vertically transmitted early-onset-sepsis in a term newborn, pneumococcal sepsis in a young infant, hospital-acquired sepsis in a neutropenic child, or staphylococcal toxic shock in an adolescent patient. Accurate characterization of the disease remains problematic, even if the Sepsis-3 concept of suspected or confirmed infection with organ dysfunction is in principle applicable to the pediatric and neonatal population (4). Similar to adults, there is a discrepancy between the global distribution of sepsis burden and the high income settings where the majority of sepsis research has been performed. In addition, ethical challenges relating to consent processes and enrolment of critically ill patients can represent obstacles to conduct interventional studies, and blood sampling availability for research faces particular challenges in young children. Finally, in 2020, too many children receive antibiotics, but too many still die from infection. We have to emphasize the importance of early detection and risk stratification, prompt administration of antimicrobials, rapid resuscitation, and supportive care for organ dysfunction (5).

【 授权许可】

CC BY