Update on pediatric sepsis: a review

Table 1 Epidemiology of pediatric sepsis in multicenter studies in developed countries since 2003

Authors, year	Country	Design Data source	Settings	Age	Incidence/prevalence	Mortality
Watson et al. 2003 [1]	USA 7 states	Retrospective Hospital discharge database	ICD-9^a coding & modified Angus criteria 1995	≤19 years	Incidence 0.56 per 1000 population (1995)	Hospital 10.3%
Hartman et al. 2013 [14]	USA 7 states	Retrospective Hospital discharge database	ICD-9^a coding & modified Angus criteria 1995, 2000, 2005	≤19 years	Incidence 0.89 per 1000 population (2005)	Hospital 8.9% (2005)
Ruth et al. 2014 [17]	USA 43 PICUs	Retrospective PHIS^b database	ICD-9^a coding & modified Angus criteria 2004–2012	≤18 years	Prevalence 6.2% (2004) to 7.7% (2012)	Hospital 14.4%; 18.9% (2004) to 12.0% (2012)
Wolfler et at. 2008 [23]	Italia 15 PICUs	Prospective	Proulx’s criteria^c 2004–2005	≤16 years	Incidence Severe sepsis 1.6% Septic shock 2.1%	ICU Severe sepsis 17.7% Septic shock^d 50.8%
Shime et al. 2011 [22]	Japan 9 PICUs	Prospective	Severe sepsis	≤15 years	Prevalence 1.4%	28-day 18.9%
Schlapbach et al. 2015 [18]	Australia/New Zealand 9 PICUs & 22 mixed ICUs	Retrospective ^dANZPIC registry	Invasive infection, sepsis, septic shock 2002–2013	<16 years	Prevalence Invasive infection 6.9% Sepsis 2.9% Septic shock 2.1%	ICU Invasive infection 3.9% Sepsis 5.6% Septic shock 17.0%
Weiss et al. 2015 (SPROUT) [19]	26 countries worldwide 128 PICUs	Point prevalence	Severe sepsis 5 days, 2013–2014	<18 years	Prevalence 8.2%	^eICU 23% ^eHospital 24%

^a ICD-9 International Classification of Diseases, 9th Revision
^b PHIS Pediatric Health Information Systems
^cProulx’s definition of septic shock was different from Goldstein’s definition, now common in the world. Briefly, Proulx’s septic shock necessitated hypotension despite 20 mls/kg of fluid administration, while Goldstein’s septic shock is defined as inadequate perfusion, regardless of blood pressure, after 40 mls/kg of fluid resuscitation
^d ANZPIC Australian and New Zealand Paediatric Intensive Care
^eThese mortality rates were only for the sites in the developed world