Epidemiology of pediatric sepsis in the pediatric intensive care unit of king Abdulaziz Medical City, Jeddah, Saudi Arabia.

BACKGROUND: Pediatric sepsis remains a significant cause of morbidity and mortality worldwide. This study aimed to identify the incidence of sepsis and septic shock among patients admitted to the pediatric intensive care unit (PICU) of a tertiary center in Saudi Arabia.  Patients' demographics and risk factors associated with sepsis-related mortality were also investigated. METHODS: A retrospective cohort study was conducted in the PICU of King Abdulaziz Medical City, Jeddah (KAMC-J). KAMC-J is a tertiary care hospital in the western region of Saudi Arabia. A total of 2389 patients admitted to the PICU of KAMC-J between January 1, 2013 and December 31, 2017 were screened and evaluated for sepsis using The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). RESULTS: Of the 2389 total admissions to the PICU, 113 patients (4.9%) met the definition of Sepsis-3; 50.4% of the 113 patients met the definition of septic shock. Most patients (66.3%) were less than 6 years old, and 52.2% were male. Eight-five patients (75.2%) had underlying comorbidities. The respiratory system was the most common primary site of infection (57.5%). Bacterial and viral infections were the most common infectious etiology with reported rates of 29.2 and 21.2%, respectively. The median duration of PICU stay was 8 days and the 28-day PICU mortality rate was 23.9%. A Pediatric Sequential Organ Failure Assessment (pSOFA) Score greater than four and a pre-existing percutaneous central venous catheter were associated with a significant increase in mortality, with adjusted odds ratios of 3.6 (95% confidence interval: 1.30-9.93) and 9.27 (95% confidence interval: 1.28-67.29), respectively. CONCLUSIONS: The incidence of sepsis in our institution is comparable to that reported internationally; however, the mortality rate is higher than that of developed countries. Nationwide studies identifying sepsis epidemiology are needed to improve the outcome of pediatric sepsis. Following international guidelines for central-line insertion and maintenance is of paramount importance.

COVID-19 in an Intrauterine Growth Restriction (IUGR) Infant with Congenital Heart Disease: Case Report and Literature Review.

In pediatrics, reported coronavirus disease-19 (COVID-19) cases showed that this category of patients usually presented with no symptoms or mild to moderate COVID-19 disease. However, infants less than one-year-old had a more severe presentation or even critical condition and respiratory failure. Patients with chronic disease and congenital heart disease (CHD) may have serious effects on course of COVID-19 in neonate and early infancy. There is very limited data about confirmed COVID-19 cases with CHD in neonates and early infancy. We report our case with confirmed COVID-19 diagnosed in the neonatal period with multiple ventricular septal defects (VSDs) and patent ductus arteriosus (PDA) who presented with respiratory distress and respiratory acidosis.