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Updated: Jul 7, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Childhood sepsis burden: pathogens/antimicrobial-resistant bacteria, 1990-2021 and 2050 forecasts
Weimin Zhu1,2, Pinlu Jiang1,2, Jiansong Yu1,3
1Department of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.
Insights
Global childhood sepsis deaths and disability-adjusted life years (DALYs) significantly decreased from 1990 to 2021. However, high-burden regions require focused interventions to further reduce the impact of childhood sepsis.
Area of Science:
- Global Health
- Pediatric Infectious Diseases
- Epidemiology
Background:
- Childhood sepsis represents a significant global health challenge.
- Understanding its burden and trends is crucial for effective prevention and treatment.
Purpose of the Study:
- To assess the global burden and trends of childhood sepsis (ages 0-14).
- To inform targeted prevention and treatment strategies by clarifying sepsis epidemiology.
Main Methods:
- Utilized the Global Burden of Disease (GBD) 2021 database for analysis.
- Included 62 pathogens, 21 drug-resistant, 84 pathogen-drug combinations, and 12 infection syndromes.
- Analyzed deaths, disability-adjusted life years (DALYs), and age-standardized rates; forecasted antimicrobial resistance (AMR) impact using ARIMA models.
Main Results:
- Global child sepsis deaths declined from 6.43 million (1990) to 2.24 million (2021); DALYs dropped from 578 million to 203 million.
- Age-standardized mortality and DALY rates showed an annual decrease of approximately 3.35% and 3.33%, respectively.
- Sub-Saharan Africa and South Asia remain high-burden regions; Streptococcus pneumoniae, Klebsiella pneumoniae, and Escherichia coli were leading pathogens.
Conclusions:
- A significant reduction in global childhood sepsis burden was observed between 1990 and 2021.
- Continued focus on high-burden regions, healthcare optimization, AMR control, vaccination, and sanitation is essential.
- Further efforts are needed to address the persistent global burden of childhood sepsis.
Background:
To assess the global burden and trends of childhood sepsis, and to evaluate whether clarifying these aspects can provide a basis for formulating targeted prevention and treatment strategies for the condition.
Methods:
Using the Global Burden of Disease (GBD) 2021 database, we analyzed sepsis in 0-14-year-olds, covering 62 pathogens (21 drug-resistant), 84 "pathogen-drug" combinations, 12 infection syndromes, and indicators (deaths, disability-adjusted life years [DALYs], age-standardized rates). Antimicrobial resistance (AMR) was defined by two counterfactual scenarios; an autoregressive integrated moving average (ARIMA) model forecast AMR-related sepsis to 2050.
Results:
From 1990 to 2021, global sepsis-related deaths among children declined from 6.43 million to 2.24 million, and DALYs dropped from 578 million to 203 million. The estimated annual percentage change (EAPC) in age-standardized mortality rate (ASMR) and DALY rate (ASDR) was -3.35 and -3.33, respectively. AMR-related sepsis burden also decreased, with notable declines in both AMR-associated and AMR-attributable deaths and DALYs. In 2021, the highest burden remained in Sub-Saharan Africa, while the lowest was in High-income regions. Leading pathogens causing child sepsis deaths included Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Bloodstream infections, lower respiratory infections, and diarrhea were the most common infection syndromes leading to sepsis-related deaths.
Conclusion:
Global childhood sepsis burden dropped, but high-burden regions (e.g., Sub-Saharan Africa, South Asia) need focus. Future efforts should optimize healthcare, strengthen AMR control, promote vaccination, and improve sanitation.
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