Microbiol Spectr. 2026 Jul 20:e0019426. doi: 10.1128/spectrum.00194-26. Online ahead of print.
ABSTRACT
Sepsis induced by a bloodstream infection (BSI) is a common cause of mortality in pediatric intensive care units. Currently, there is a lack of data for sepsis from southwest China. This study involved a 10-year retrospective analysis to summarize pathogen and drug resistance features of sepsis induced by BSI and analyze risk factors for 28-day mortality. A total of 311 pediatric patients with sepsis induced by a BSI were identified with the following characteristics: males, 60.8%; average age, 26 (5.6, 108.0) months; and 28-day mortality rate, 20.3%. The incidence of septic shock and acute kidney injury was 51.8% and 26.0%, respectively. Polymicrobial growth was demonstrated in 11 cultures. A total of 305 pathogens were isolated, as follows: 164 strains (53.8%) were gram-positive bacteria, 125 strains (41.0%) were gram-negative bacteria, and 16 strains (5.2%) were fungi. The most frequently isolated pathogens were Escherichia coli, coagulase-negative Staphylococcus, and Staphylococcus aureus. Risk factors for mortality were the Phoenix Sepsis Score (PSS) (>5.5), neutropenia, acute kidney injury, and mechanical ventilation. Risk factors for community-acquired sepsis were consistent within the entire cohort. The PSS was a risk factor for hospital-acquired sepsis. E. coli had the highest levels of cephalosporin and fluoroquinolone resistance, while Klebsiella pneumoniae had the highest level of carbapenem resistance. In conclusion, it is crucial to monitor multidrug resistance in the local geographic area and select antibiotics based on the results of drug sensitivity tests.IMPORTANCEThis study provides crucial 10-year data for pediatric sepsis from bloodstream infections in southwest China, a previously underrepresented region. The local pathogen spectrum was identified, revealing high rates of multidrug resistance in key gram-negative bacteria, like Escherichia coli and Klebsiella pneumoniae. Furthermore, critical risk factors for 28-day mortality, including the Phoenix Sepsis Score, neutropenia, acute kidney injury, and mechanical ventilation, were noted. These findings are vital for clinicians and facilitate early risk stratification, guide empirical antibiotic therapy based on local resistance patterns, and ultimately enhance management strategies to reduce mortality in this vulnerable population. The data fills a significant regional knowledge gap and has direct implications for improving pediatric sepsis outcomes.
PMID:42474196 | DOI:10.1128/spectrum.00194-26