Sepsis in the Pediatric Emergency Department of the Gabriel Toure Teaching Hospital

Abstract

Introduction: A potentially fatal condition, sepsis is characterized by large and repeated discharges in the blood of pathogens and their poisons from an outbreak, creating a serious systemic infection leading to organ dysfunction. Its severity becomes maximum when, in certain circumstances relating to the nature of the germ and the terrain, it is complicated by a toxiinfectious shock with an always formidable prognosis. In Mali, there are few national studies on sepsis and its prevalence. The objective of our study was to study the clinical aspects of sepsis in the pediatric emergency department of the CHU Gabriel Touré. Materials and Method: This was a retrospective and descriptive study from January 1, 2017 to December 31, 2018, i.e. 24 months in children aged 1 month to 15 years. The data was collected on an individual survey form from the files of hospitalized patients and the permanent register of the CVD (Vaccine Development Center). Results: During the study period, 5,919 children hospitalized. Sepsis was evoked in 378, of which 43 patients met our inclusion criteria, i.e. a frequency of 11.38%. The age group of 1 to 24 months was the most affected with 53.49%. The sex ratio was 0.34. All patients (100%) presented with a high fever on admission followed by respiratory distress (48.84%) and deterioration of general condition (34.88%). The portal of entry was mainly cutaneous and osteoarticular with 41.86% and 18.60%. Staphylococcus aureus was the most isolated germ in blood culture (25 cases out of 37 positive blood cultures), i.e. 67.57%. Tri-antibiotic therapy and bi-antibiotic therapy were the most used in equal proportions, 83.72%. The 3rd generation cephalosporin's were the most prescribed. The evolution was favorable in 55.82% against 44.18% of deaths. Conclusion: There is still a lot of progress to be made concerning the diagnosis, the therapeutic approach and the monitoring of the patients because the mortality remains high.