Septicemia in a Pediatric Unit: A 20-Year Study

Clinical and bacteriological data of 170 patients with septicemia, treated at the Children's Hospital of Turku University over a 20-year period (1949–1968), were reviewed. The overall incidence of septicemia was 5 per 1 000 admissions, and this incidence did not change during the 20-year period. However, the incidence was markedly higher in the youngest age groups than at later ages. Although no time-related changes occurred in the incidence of septicemias caused by Staphylococcus aureus and most gram-negative organisms, the incidence of Escherichia coli septicemias increased considerably between 1959 and 1968. E. coli was most often found in the age groups under 6 months, and Haemophilus influenzae in the age groups under 4 years. The portal of entry of the causative agents was most often the respiratory tract.19% of the patients died. The mortality rate did not change during the study period. Five factors were found, significantly predisposing to fatality in septicemic children. These were: (1) age less than 1 month; (2) underlying disease; (3) metastatic complications of bacteremia; (4) granulocytopenia; and (5) lack of fever. Items (1), (4) and (5) often occurred simultaneously. During the last 5 years of the study the predisposing roles of instrumental manipulations and underlying disease increased. Anemia was verified in 59% of the patients. Although fever, leucocytosis, and elevated erythrocyte sedimentation rates (ESR) were common findings, 13% had no fever, 35% had normal leucocyte counts, and 39% had normal ESR.