Pediatric sepsis in pediatric intensive care units remains a major global health concern, with an average prevalence of 52.6% and an average mortality rate of 30.5%. This systematic review provides a comprehensive analysis of pediatric sepsis across diverse settings, highlighting significant regional and clinical variations in outcomes. Early recognition and timely administration of antibiotics are crucial in reducing mortality, while managing underlying comorbidities such as severe malnutrition, multiorgan dysfunction, and late hospital admission plays a pivotal role in improving the outcome. Gram-negative bacteria, particularly Escherichia coli and Klebsiella spp., were found to be the most prevalent pathogens, with an antimicrobial resistance rate of 36.5%. Moreover, viral DNAemia, including pathogens like torque teno virus and adenovirus, also contributes significantly to immune suppression and secondary infections. Geographical and socioeconomic disparities were evident, with higher mortality rates observed in rural areas and among indigenous populations. The results underscore the urgent need for region-specific strategies to enhance infection control, implement antimicrobial stewardship, and address healthcare access inequalities. In conclusion, this review highlighted the importance of targeted interventions, novel antimicrobial therapies, and the role of precision medicine in reducing the global burden of pediatric sepsis. Further research focusing on the socioeconomic determinants of sepsis outcomes is critical for optimizing care and improving survival rates in critically ill children.
Key words: Pediatric sepsis, pediatric intensive care unit (PICU), severe sepsis, septic shock, mortality
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