1205. Characteristics of Hospitalized Children Diagnosed with Sepsis in Amman, Jordan
Session: Poster Abstract Session: Other Bacterial Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Rule out sepsis (ROS) is a common reason for hospitalization of children worldwide.

Methods: To determine characteristics of children diagnosed with ROS in Amman, Jordan,  we conducted a 1 year prospective viral surveillance study in children <2 years of age admitted with respiratory symptoms and/or fever at the government-run hospital, Al-Basheer.  Clinical and demographic data were collected. Nasal/throat swabs were collected, placed into lysis buffer, aliquoted, and frozen at -80°C. Specimen aliquots were shipped to Vanderbilt and tested by real-time RT-PCR for respiratory syncytial virus (RSV), metapneumovirus (HMPV), rhinovirus (HRV), influenza A and B, and parainfluenza virus 3 (PIV3).

Results: A total of 732 subjects were enrolled.  The median ages were 3.5 months, with 59% males. 63 (9%) had an underlying medical condition, 8 (1%) attended day care, 524 (72%) subjects were exposed to smokers, and 54 (8%) were admitted to the ICU.  190/732 (25.9%) of the subjects were diagnosed with ROS and 539 (74%) tested positive for a virus.  Subjects diagnosed with ROS were less likely to present with cough, congestion, shortness of breath,  (p<0.001, p=0.048, p<0.001) and more likely to present with vomiting and diarrhea (p<0.001, p<0.001). Subjects diagnosed with ROS had a lower mean and median age (1.5 vs. 7.1 and 1.2 vs. 5.5 months, p<0.01 for both) compared to subjects with other diagnoses. Their median length of stay at the hospital was longer, (6 vs 2 days, p<0.001), were less likely to require oxygen (14% vs. 30%, p<0.01), less likely to test positive for RSV (Table 1) but more likely to die in the hospital (2% vs. 0%, p=0.022).

Table 1.

Virus

ROS 

N=190 (%)

All other diagnoses 

N=542 (%)

p-value

RSV

50 (26%)

330 (61%)

<0.01

hMPV

5 (3%)

22 (4%)

0.37

Influenza A

2 (1%)

12 (1%)

0.32

Influenza B

2 (1%)

8 (1)

0.67

PIV3

4 (2%) 14 (3%) 0.71

 




Conclusion: Children diagnosed with ROS presented with more severe illness, as indicated by their average length of hospital stay and increased mortality compared to other diagnoses.  In addition, they presented less often with RSV.  
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Subject Category: P. Pediatric and perinatal infections

Katherine Kudyba, BS1, Najwa Khuri-Bulos, MD, CIC, FIDSA2, Ryan Lang, BS1, Samir Faouri, MD3, Asem Shehabi, PhD4, Wenli Wang5, Ben Saville, PhD5, John Williams, MD5 and Natasha Halasa, MD MPH5, (1)Vanderbilt University School of Medicine, Nashville, TN, (2)Division of Infectious Disease, Jordan University Hospital, Jordan, (3)Al-Basheer, Amman, Jordan, (4)Jordan University, Amman, Jordan, (5)Vanderbilt University Medical Center, Nashville, TN

Disclosures:

K. Kudyba, None

N. Khuri-Bulos, None

R. Lang, None

S. Faouri, None

A. Shehabi, None

W. Wang, None

B. Saville, None

J. Williams, MedImmune: Consultant, Consulting fee
Novartis: Consultant, Consulting fee
Quidel: Scientific Advisor, Consulting fee

N. Halasa, UBS Foudation: Grant Investigator, Grant recipient

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.