Clinical and Laboratory Characteristics of Sepsis in under 5 Year Pneumonia Children with Diarrhoea

Abstract

Sepsis is a potential complication of pneumonia among under 5-year-old children. This study aimed to determine the symptom, diagnosis, causes, treatment, management and prevention of sepsis in pneumonia children. In this study 208 under 5-year-old pneumonia children with sepsis (cases) and without sepsis (control) attending at icddr,b hospital in Bangladesh were included. The mortality rate(odds ratio [OR] = 3.02, 95% confidence interval [CI], 1.11-8.64, p < 0.027) is high among the children with sepsis (odds ratio [OR] = 3.04, 95% confidence interval [CI], 1.11-8.64, p < 0.05) specifically the children under age of 2 months (odds ratio [OR] = 2.48, 95% confidence interval [CI], 1.22-5.10, p < 0.05). Higher gestational age(weeks) (p<0.002) increases sepsis risk with bacteria in our study. In a multivariate logistic regression analysis showed that clinical dehydration (odds ratio [OR] = 1.89, 95% confidence interval [CI], 1.11-3.23, p < 0.05) is the common clinical sign and change of total wbc count(p<.004) , immature poly(p<.044), bacterial growth on blood culture(p<.037) are the laboratory characteristics of sepsis. Ampicilin and gentamicin injection is used as a first line treatment for sepsis at icddr,b, with an excellent survival rate of 96%. Severely ill patients needed fluid resustication and bubble CPAP.Coagulase-negative staphylococciwas isolated in 8% of clinical sepsis followed by Acinetobacter species (2.4%). Imipenem has been shown 100% sensitive against bacterial isolates from blood culture of the children. In resource poor setting simple clinical and laboratory characteristics in these children will help to have prompt early diagnosis and treatment that will help to reduce mortality.