[Sepsis in childhood: epidemiological profile and microbiologic diagnosis]

OBJECTIVE: To establish an etiological and epidemiological profile of sepsis among children that were hospitalized in the Hospital Infantil Albert Sabin - HIAS (a reference public hospital for all pediatric diseases in the state of Ceará), since this disease has been of high prevalence in this hospital with considerable mortality. METHODS: All children admitted in the hospital from January 1993 to June 1994, who presented sepsis or developed nosocomial sepsis and presented positive blood cultures were studied prospectively. The epidemiologic study was conducted by gathering information in questionnaire form about the following factors: sex, age, reference area, nutritional status, complaints at admission, sepsis origin (nosocomial or not), and outcome for each case. Microbiologic analysis were formed by means of blood culture, concomitant with sensitivity tests of the isolated bacteria to the most commonly used antibiotics. All samples were processed at the Laboratory of Microbiology of the Health's Science Center of the Federal University in Ceará. RESULTS: 205 children were studied of which 17 presented two septic episodes, making a total of 222 episodes in the period. 56.1% of them were male, 81.4% were less than one-year old, 71.1% were malnourished children and 60.5% came from the countryside of the Ceará State. At the moment of their admission, two-thirds of the children presented gastrointestinal problems (diarrhea) or respiratory complaints, whereas 47.7% of the episodes of sepsis were acquired in hospital. The mortality rate was 56.1%. Blood culture test showed a predominance of the following bacteria: Staphylococcus aureus (24.8%), Klebsiella pneumoniae (22.6%), Pseudomonas aeruginosa (15.2%), Enterobacter sp (11.2%), Escherichia coli (7%), and others (19.2%). CONCLUSIONS: The epidemiological profile of the population in this study was the following: these children were less than one-year old, the majority of them were malnourished and when they were hospitalized, presented with symptoms of diarrhea or respiratory disease. 40% of them had a disease or situation that favored the development of sepsis. The predominant bacterias were Staphylococcus aureus and Klebsiella pneumoniae.