RESEARCH ARTICLE
Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study Mohammod Jobayer Chisti1,2*, Mohammed Abdus Salam3, Pradip Kumar Bardhan1,2, Abu S. G. Faruque1, Abu S. M. S. B. Shahid1, K. M. Shahunja1, Sumon Kumar Das1, Md Iqbal Hossain1,2, Tahmeed Ahmed1 1 Centre for Nutrition & Food Security (CNFS), International Centre for Diarhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh, 2 Dhaka Hospital, icddr,b, Dhaka, Bangladesh, 3 Research & Clinical Administration and Strategy (RCAS), icddr,b, Dhaka, Bangladesh * [email protected]
Abstract OPEN ACCESS Citation: Chisti MJ, Salam MA, Bardhan PK, Faruque ASG, Shahid ASMSB, Shahunja KM, et al. (2015) Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study. PLoS ONE 10 (10): e0139966. doi:10.1371/journal.pone.0139966 Editor: Ray Borrow, Public Health England, UNITED KINGDOM Received: May 29, 2015 Accepted: September 18, 2015 Published: October 6, 2015 Copyright: © 2015 Chisti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Due to ethical restriction, specifically in regard to patient identifying information, data are available upon request from the Research & Clinical Administration and Strategy (RCAS) of icddr,b (http://www.icddrb.org/) for researchers who meet the criteria for access to confidential data. Funding: This research study was funded by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b; grant no Gr- 00233) and its donors, which provide unrestricted support to ICDDR, B for its operations and research. MJC
Background In developing countries, there is no published report on predicting factors of severe sepsis in severely acute malnourished (SAM) children having pneumonia and impact of fluid resuscitation in such children. Thus, we aimed to identify predicting factors for severe sepsis and assess the outcome of fluid resuscitation of such children.
Methods In this retrospective case-control study SAM children aged 0–59 months, admitted to the Intensive Care Unit (ICU) of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh from April 2011 through July 2012 with history of cough or difficult breathing and radiologic pneumonia, who were assessed for severe sepsis at admission constituted the study population. We compared the pneumonic SAM children with severe sepsis (cases = 50) with those without severe sepsis (controls = 354). Severe sepsis was defined with objective clinical criteria and managed with fluid resuscitation, in addition to antibiotic and other supportive therapy, following the standard hospital guideline, which is very similar to the WHO guideline.
Results The case-fatality-rate was significantly higher among the cases than the controls (40% vs. 4%; p
Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study Mohammod Jobayer Chisti1,2*, Mohammed Abdus Salam3, Pradip Kumar Bardhan1,2, Abu S. G. Faruque1, Abu S. M. S. B. Shahid1, K. M. Shahunja1, Sumon Kumar Das1, Md Iqbal Hossain1,2, Tahmeed Ahmed1 1 Centre for Nutrition & Food Security (CNFS), International Centre for Diarhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh, 2 Dhaka Hospital, icddr,b, Dhaka, Bangladesh, 3 Research & Clinical Administration and Strategy (RCAS), icddr,b, Dhaka, Bangladesh * [email protected]
Abstract OPEN ACCESS Citation: Chisti MJ, Salam MA, Bardhan PK, Faruque ASG, Shahid ASMSB, Shahunja KM, et al. (2015) Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study. PLoS ONE 10 (10): e0139966. doi:10.1371/journal.pone.0139966 Editor: Ray Borrow, Public Health England, UNITED KINGDOM Received: May 29, 2015 Accepted: September 18, 2015 Published: October 6, 2015 Copyright: © 2015 Chisti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Due to ethical restriction, specifically in regard to patient identifying information, data are available upon request from the Research & Clinical Administration and Strategy (RCAS) of icddr,b (http://www.icddrb.org/) for researchers who meet the criteria for access to confidential data. Funding: This research study was funded by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b; grant no Gr- 00233) and its donors, which provide unrestricted support to ICDDR, B for its operations and research. MJC
Background In developing countries, there is no published report on predicting factors of severe sepsis in severely acute malnourished (SAM) children having pneumonia and impact of fluid resuscitation in such children. Thus, we aimed to identify predicting factors for severe sepsis and assess the outcome of fluid resuscitation of such children.
Methods In this retrospective case-control study SAM children aged 0–59 months, admitted to the Intensive Care Unit (ICU) of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh from April 2011 through July 2012 with history of cough or difficult breathing and radiologic pneumonia, who were assessed for severe sepsis at admission constituted the study population. We compared the pneumonic SAM children with severe sepsis (cases = 50) with those without severe sepsis (controls = 354). Severe sepsis was defined with objective clinical criteria and managed with fluid resuscitation, in addition to antibiotic and other supportive therapy, following the standard hospital guideline, which is very similar to the WHO guideline.
Results The case-fatality-rate was significantly higher among the cases than the controls (40% vs. 4%; p
