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A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
International survey on immunological diagnostics in children with sepsis
Nina Schöbi1, Philipp K A Agyeman1, Vanessa Sancho-Shimizu2,3
1Division of Pediatric Infectious Disease, Department of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, CH-3010 Switzerland.
Insights
Pediatric sepsis investigations show significant variability among physicians. Developing standardized guidelines for immunological and genetic testing in children after sepsis is crucial for consistent patient care.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Genetics
Background:
- Sepsis is a major cause of child mortality and disability.
- Undiagnosed inborn errors of immunity can lead to severe infections in children.
- In up to 50% of cases, previously healthy children with healthcare access are affected by sepsis.
Purpose of the Study:
- To investigate current physician practices for follow-up immunological investigations in pediatric patients after community-acquired sepsis.
- To identify variability and potential gaps in diagnostic approaches.
Main Methods:
- A global survey of physicians involved in pediatric sepsis care.
- Data collected from May 2023 to March 2024.
- Analysis of 168 responses from 50 countries.
Main Results:
- Significant variability observed in investigative approaches for pediatric sepsis.
- Physicians with more experience and those in Pediatric Infectious Diseases showed some trends, but overall inconsistency was high.
- Only 7% of respondents reported using standardized sepsis-specific guidelines for immunological investigations.
Conclusions:
- Current practices for investigating pediatric sepsis are highly variable.
- A consensus-based algorithm for standardized immunological and genetic testing is needed.
- Standardized approaches can guide clinical practice and future research in pediatric sepsis.
Background:
Sepsis is a leading cause of death and disability in children and it affects in up to 50% previously healthy children who have access to health care. Undiagnosed inborn error of immunity, considered to be rare at population level, may underlie host immune dysregulation and result in exceptionally high risk for life-threatening infections.
Methods:
From May 2023 to March 2024, physicians involved in the care of children with sepsis were questioned regarding their follow-up investigation practice in paediatric patients after community-acquired sepsis. This survey was distributed through three international societies.
Results:
A total of 168 responses from 50 countries were analysed. The majority (82%), reported to have more than 10 years of experience. More than half (53%) stated to work in Paediatric Infectious Diseases. Major variability across respondents was observed in the approach to different scenarios of patients with sepsis. Severity of presentation, and unusual presentations increased the likelihood of ordering immunological investigations. Only 7% reported to have access to a standardised sepsis specific guideline to immunologically investigate paediatric patients after sepsis.
Conclusion:
The results of this survey highlight a broad range of practices surrounding immunological investigations of children with sepsis. A consensus-based algorithm for standardised immunological and genetic testing in paediatric patients after sepsis could guide practice and inform future studies in the field.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s44253-026-00120-w.
