{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:50:19Z","timestamp":1791726619821,"version":"4.3.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"5","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Most multicenter studies of US pediatric sepsis epidemiology use administrative data or focus on pediatric intensive care units. We conducted a detailed medical record review to describe sepsis epidemiology in children and young adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a convenience sample of hospitals in 10 states, patients aged 30 days\u201321 years, discharged during 1 October 2014\u201330 September 2015, with explicit diagnosis codes for severe sepsis or septic shock, were included. Medical records were reviewed for patients with documentation of sepsis, septic shock, or similar terms. We analyzed overall and age group\u2013specific patient characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 736 patients in 26 hospitals, 442 (60.1%) had underlying conditions. Most patients (613 [83.3%]) had community-onset sepsis, although most community-onset sepsis was healthcare associated (344 [56.1%]). Two hundred forty-one patients (32.7%) had outpatient visits 1\u20137 days before sepsis hospitalization, of whom 125 (51.9%) received antimicrobials \u226430 days before sepsis hospitalization. Age group\u2013related differences included common underlying conditions (&amp;lt;5 years: prematurity vs 5\u201312 years: chronic pulmonary disease vs 13\u201321 years: chronic immunocompromise); medical device presence \u226430 days before sepsis hospitalization (1\u20134 years: 46.9% vs 30 days\u201311 months: 23.3%); percentage with hospital-onset sepsis (&amp;lt;5 years: 19.6% vs \u22655 years: 12.0%); and percentage with sepsis-associated pathogens (30 days\u201311 months: 65.6% vs 13\u201321 years: 49.3%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our data suggest potential opportunities to raise sepsis awareness among outpatient providers to facilitate prevention, early recognition, and intervention in some patients. Consideration of age-specific differences may be important as approaches are developed to improve sepsis prevention, risk prediction, recognition, and management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad218","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T12:21:02Z","timestamp":1681993262000},"source":"Crossref","is-referenced-by-count":19,"title":["Epidemiology of Sepsis in US Children and Young Adults"],"prefix":"10.1093","volume":"10","author":[{"given":"Shelley S","family":"Magill","sequence":"first","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew R P","family":"Sapiano","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runa","family":"Gokhale","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Nadle","sequence":"additional","affiliation":[{"name":"California Emerging Infections Program , Oakland, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Johnston","sequence":"additional","affiliation":[{"name":"Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment , Denver, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Brousseau","sequence":"additional","affiliation":[{"name":"Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment , Denver, Colorado 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Perlmutter","sequence":"additional","affiliation":[{"name":"Infectious Disease Epidemiology and Outbreak Response Bureau, Maryland Department of Health , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Lynfield","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health , St Paul, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3705-1672","authenticated-orcid":false,"given":"Malini","family":"DeSilva","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health , St Paul, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla","family":"Sievers","sequence":"additional","affiliation":[{"name":"Epidemiology and Response Division, New Mexico Department of Health , Santa Fe, New Mexico , 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The trajectories of sepsis, 2012\u20132018","volume":"48","author":"Buchman","year":"2020","journal-title":"Crit Care Med"},{"key":"2023050914443092900_ofad218-B9","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1097\/CCM.0000000000003817","article-title":"Epidemiology of hospital-onset versus community-onset sepsis in U.S. hospitals and association with mortality: a retrospective analysis using electronic clinical data","volume":"47","author":"Rhee","year":"2019","journal-title":"Crit Care Med"},{"key":"2023050914443092900_ofad218-B10","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1097\/PCC.0000000000000225","article-title":"Pediatric severe sepsis in US children's hospitals","volume":"15","author":"Balamuth","year":"2014","journal-title":"Pediatr Crit Care Med"},{"key":"2023050914443092900_ofad218-B11","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1097\/PCC.0b013e3182917fad","article-title":"Trends in the epidemiology of pediatric severe sepsis","volume":"14","author":"Hartman","year":"2013","journal-title":"Pediatr Crit Care Med"},{"key":"2023050914443092900_ofad218-B12","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1097\/INF.0000000000002669","article-title":"Epidemiology, clinical and microbiologic profile and risk factors for inpatient mortality in pediatric severe sepsis in the United States from 2003 to 2014: a large population analysis","volume":"39","author":"Thavamani","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"2023050914443092900_ofad218-B13","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.15214","article-title":"Comparison of outpatient health care use before and after pediatric severe sepsis","volume":"3","author":"Carlton","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2023050914443092900_ofad218-B14","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1097\/PCC.0000000000000760","article-title":"Comparison of pediatric severe sepsis managed in U.S. and European ICUs","volume":"17","author":"Giuliano","year":"2016","journal-title":"Pediatr Crit Care Med"},{"key":"2023050914443092900_ofad218-B15","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.6004","article-title":"Assessment of health care exposures and outcomes in adult patients with sepsis and septic shock","volume":"3","author":"Fay","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2023050914443092900_ofad218-B16","author":"Centers for Disease Control and Prevention"},{"key":"2023050914443092900_ofad218-B17","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/01.PCC.0000149131.72248.E6","article-title":"International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics","volume":"6","author":"Goldstein","year":"2005","journal-title":"Pediatr Crit Care Med"},{"key":"2023050914443092900_ofad218-B18","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1378\/chest.101.6.1644","article-title":"Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis","volume":"101","author":"Bone","year":"1992","journal-title":"Chest"},{"key":"2023050914443092900_ofad218-B19","doi-asserted-by":"crossref","DOI":"10.1001\/jamapediatrics.2017.2352","article-title":"Adaptation and validation of a pediatric sequential organ failure assessment score and evaluation of the Sepsis-3 definitions in critically ill children","volume":"171","author":"Matics","year":"2017","journal-title":"JAMA Pediatr"},{"key":"2023050914443092900_ofad218-B20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/CCE.0000000000000635","article-title":"Frequency and types of healthcare encounters in the week preceding a sepsis hospitalization: a systematic review","volume":"4","author":"Flannery","year":"2022","journal-title":"Crit Care Explor"},{"key":"2023050914443092900_ofad218-B21","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1097\/CCM.0000000000002960","article-title":"Healthcare utilization and infection in the week prior to sepsis hospitalization","volume":"46","author":"Liu","year":"2018","journal-title":"Crit Care Med"},{"key":"2023050914443092900_ofad218-B22","doi-asserted-by":"crossref","first-page":"135","DOI":"10.4037\/ajcc2021456","article-title":"The characteristics and outcomes of clinic visits immediately preceding sepsis hospitalization","volume":"30","author":"Miller","year":"2021","journal-title":"Am J Crit Care"},{"key":"2023050914443092900_ofad218-B23","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1097\/CCM.0000000000002973","article-title":"Missed opportunities for better sepsis care or misplaced blame? 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