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Pediatrics

High Prevalence of Carbapenem-Resistant Sepsis in Pediatric Acute Liver Failure

Strategic Insights

— 1 min read

According to a recent study published in the Pediatric Infectious Disease Journal, investigators have found a high prevalence of carbapenem-resistant sepsis in pediatric acute liver failure (PALF). The study aimed to explore the prevalence, predictors, and outcomes of infections in PALF patients. The research revealed that 46.21% of PALF patients developed sepsis, with 16.8% having culture-positive sepsis. The most common site of culture positivity was bronchoalveolar fluid, followed by blood. Notably, more than 80% of cultures grew Gram-negative organisms with high rates of carbapenem and multidrug resistance.

Key Takeaways:

  • The study included 422 patients with PALF, of whom 195 (46.21%) developed sepsis and 71 (16.8%) had culture-positive sepsis.
  • Bronchoalveolar fluid was the commonest site of culture positivity, followed by blood, in patients with culture-positive sepsis.
  • Over 80% of cultures grew Gram-negative organisms, with 77.1% showing carbapenem resistance and 60% showing multidrug resistance.
  • Patients with culture-negative sepsis had lower native liver survival and overall survival rates compared to those without sepsis.
  • Culture-positive severe sepsis patients had significantly lower native liver survival and overall survival rates at day 28.
  • Intensive care unit stay, mechanical ventilation, grade 3-4 hepatic encephalopathy, and use of extracorporeal liver support systems were associated with culture-positive sepsis.
  • Patients with culture-positive sepsis had outcomes comparable to those without sepsis, but severe sepsis patients had lower survival rates.

Statistics:

  • 46.21% of PALF patients developed sepsis, with 16.8% having culture-positive sepsis.
  • 80.5% of cultures grew Gram-negative organisms.
  • 77.1% of Gram-negative organisms showed carbapenem resistance.
  • 60% of Gram-negative organisms showed multidrug resistance.
  • 33.3% of culture-positive severe sepsis patients had significantly lower native liver survival rates at day 28.
  • 42.9% of culture-positive severe sepsis patients had significantly lower overall survival rates at day 28.

Sources:

  • Bacterial and Fungal Infections In Pediatric Acute Liver Failure and Their Impact On Clinical Outcomes. Pediatric Infectious Disease Journal, 2025;44(7):676-682.
  • Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.
  • Seema Alam, Institute of Liver and Biliary Sciences, Dept. of Pediatric Hepatology, D1, New Delhi 110070, India.

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