Prevalence, severity, and outcomes of sepsis in Australian and New Zealand children

Abstract

Background: Sepsis is the leading cause of early childhood death worldwide, with an estimated 4 million children dying from this final common pathway for severe infections every year. The burden of disease in Australia and New Zealand is unknown, including mortality, duration of hospitalisation, requirement for intensive care and organ support therapies, and long-term functional outcome in sepsis survivors. Early markers of severe disease and predictors of poor outcome in childhood sepsis are unknown.

Sepsis-related hospital costs are estimated at $4 billion per annum for children and $12 billion per annum for adults in the United States. The cost of hospitalisation for children with sepsis in Australia and New Zealand is unknown.

Variation in guidelines for sepsis treatment in Australia and New Zealand, and adherence to such guidelines, is unknown.

The microbiology and resistance patterns of bacterial pathogens in children treated for sepsis in Australia and New Zealand are unknown. Whether current empiric antibiotic recommendations are appropriate to cover bacterial pathogens causing sepsis in Australia and New Zealand is unknown.

The prevalence and outcomes in subgroups of vulnerable, high risk children, including those receiving cancer chemotherapy, those self identifying as of Aboriginal or Torres Strait Islander or Maori ethnicity, those with chronic medical conditions, and infants or neonates who are treated for sepsis are unknown.

Rationale: Baseline observational data is required to answer fundamental aspects of sepsis care for children in Australia and New Zealand, and to plan future interventional studies.

Defining characteristics, prevalence, severity, resource utilisation, cost, variation in care, and antimicrobial stewardship are all important and unexplored components of the paediatric sepsis research landscape that will be addressed by this study.

Aim: To describe the epidemiology of hospitalised children treated for sepsis in Australia and New Zealand.