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Vaccine preventable infections and multiple organ dysfunction syndrome in critically ill children in China

Qing Li Zhang1, Chao Min Wan, Noni E MacDonald

  • 1Department of Pediatrics, West China Second University Hospital, Sichuan University, Sichuan, China.

The Pediatric Infectious Disease Journal
|January 24, 2009
PubMed

Insights

Multiple organ dysfunction syndrome (MODS) is a significant cause of mortality in pediatric intensive care units (PICUs) in China. Introducing conjugated vaccines for Haemophilus influenzae type b and Streptococcus pneumoniae could reduce infection-related MODS cases.

Area of Science:

  • Pediatric Critical Care Medicine
  • Infectious Diseases
  • Epidemiology

Background:

  • Multiple organ dysfunction syndrome (MODS) is a leading cause of mortality in pediatric intensive care units (PICUs).
  • As developing nations advance, PICU care becomes more accessible, necessitating studies on conditions like MODS in these regions.
  • This study examines MODS in a Chinese PICU, comparing findings with international data.

Purpose of the Study:

  • To investigate the incidence, characteristics, and outcomes of MODS in a Chinese PICU.
  • To compare the epidemiology of MODS in China with that in other countries.
  • To identify potential strategies for reducing MODS-related mortality in China.

Main Methods:

  • A retrospective 5-year audit (2001-2006) of MODS cases was conducted.
  • Data were collected from a 6-bed PICU at the Second Hospital of Lanzhou University, China.
  • Patient demographics, underlying causes, organ system involvement, and mortality rates were analyzed.

Main Results:

  • Of 332 PICU patients, 176 (53%) had MODS, with a mean age of 35 months; 60% were under 1 year old.
  • Infectious diseases were the primary cause (73%), with 24% linked to vaccine-preventable infections (Haemophilus influenzae b, Streptococcus pneumoniae, Neisseria meningitidis).
  • The overall MODS case fatality rate was 49%, comparable to developing countries but higher than industrialized nations. Respiratory and cardiovascular systems were most frequently affected.

Conclusions:

  • MODS represents a substantial mortality burden in Chinese PICU patients.
  • Infection-related MODS in Chinese PICUs could be reduced by implementing conjugated Haemophilus influenzae type b and pneumococcal vaccines.
  • Vaccination strategies could help align China's MODS outcomes with those observed in industrialized countries.
Abstract

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