Evidence map›Paper›PMID 39117931›Full record

ArticleInfection2025

Risk factors for prolonged infection and secondary infection in pediatric severe sepsis.

Zachary Aldewereld, Brendan Connolly, Russell K Banks, Ron Reeder, Richard Holubkov, Robert A Berg, David Wessel, Murray M Pollack, Kathleen Meert, Mark Hall and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Zachary AldewereldDivision of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh, 4401 Penn Ave, FP Suite 2000, Pittsburgh, PA, 15224, USA. aldewereldzt@upmc.edu.ORCID http://orcid.org/0000-0003-4367-9036
Brendan ConnollyUniversity of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Russell K BanksDepartment of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Ron ReederDepartment of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Richard HolubkovDepartment of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Robert A BergDepartment of Anesthesiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
David WesselDivision of Critical Care Medicine, Department of Pediatrics, Children's National Hospital, Washington, DC, USA.
Murray M PollackDivision of Critical Care Medicine, Department of Pediatrics, Children's National Hospital, Washington, DC, USA.
Kathleen MeertDivision of Critical Care Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA.
Mark HallDivision of Critical Care Medicine, Department of Pediatrics, The Research Institute at Nationwide Children's Hospital Immune Surveillance Laboratory, and Nationwide Children's Hospital, Columbus, OH, USA.
Christopher NewthDivision of Pediatric Critical Care Medicine, Department of Anesthesiology and Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA.
John C LinDivision of Critical Care Medicine, Department of Pediatrics, St. Louis Children's Hospital, St. Louis, MO, USA.
Allan DoctorDivision of Critical Care Medicine, Department of Pediatrics, St. Louis Children's Hospital, St. Louis, MO, USA.
Tim CornellDivision of Critical Care Medicine, Department of Pediatrics, C. S. Mott Children's Hospital, Ann Arbor, MI, USA.
Rick E HarrisonDivision of Critical Care Medicine, Department of Pediatrics, Mattel Children's Hospital at University of California Los Angeles, Los Angeles, CA, USA.
Athena F ZuppaDepartment of Anesthesiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
J Michael DeanDepartment of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Joseph A CarcilloDivision of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh, 4401 Penn Ave, FP Suite 2000, Pittsburgh, PA, 15224, USA. carcilloja@ccm.upmc.edu.

Funding

Data Coordinating Center for the Collaborative Pediatric Critical Care Research NetworkU01HD049934 · NICHD · UNIVERSITY OF UTAH · PI DEAN, JONATHAN MICHAEL · 2005 to 2020
$35.2M
Inflammation Phenotypes in Pediatric Sepsis Induced Multiple Organ Failure RenewalR01GM108618 · NIGMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JOSEPH A CARCILLO · 2014 to 2026
$5.4M
Physiologically Guided Ventilator Strategies in ChildrenU10HD050012 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI NEWTH, CHRISTOPHER JOHN · 2005 to 2014
$3.7M
Neurodevelopmental Outcome after Cardiac Intensive CareU10HD049981 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI WESSEL, DAVID LLOYD · 2005 to 2014
$3.7M
Collaborative Pediatric Critical Care Research NetworkU10HD050096 · NICHD · WAYNE STATE UNIVERSITY · PI MEERT, KATHLEEN L. · 2005 to 2014
$3.2M
Metoclopramide prevents PICU nosocomial infectionU10HD049983 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CARCILLO, JOSEPH A · 2005 to 2014
$3.1M
Pediatric Critical Care Research Network at Children's Hospital of PhiladelphiaU10HD063108 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI BERG, ROBERT ALLEN · 2010 to 2014
$1.4M
Predicting Morbidity from Pediatric Critical CareU10HD063114 · NICHD · PHOENIX CHILDREN'S HOSPITAL · PI DALTON, HEIDI J, LUND, DENNIS P · 2010 to 2014
$1.4M
Collaborative Pediatric Research Critical Care Network(U10)U10HD063106 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SHANLEY, THOMAS P. · 2010 to 2014
$1.3M
Collaborative Pediatric Critical Care Research Network (CPCCRN)RL1HD107779 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JOSEPH A CARCILLO · 2021 to 2026
$942k
Eunice Kennedy Shriver National Institute of Child Health and Human Development 5U01HD049934National Institute of Child Health and Human Development U01HD049934National Institute of Child Health and Human Development U10HD049981National Institute of Child Health and Human Development U10HD050012National Institute of Child Health and Human Development U10HD050096National Institute of Child Health and Human Development U10HD063108NICHD NIH HHS RL1 HD107779NICHD NIH HHS U01 HD049934NICHD NIH HHS U10 HD049981NICHD NIH HHS U10 HD049983NICHD NIH HHS U10 HD050012NICHD NIH HHS U10 HD050096NICHD NIH HHS U10 HD063106NICHD NIH HHS U10 HD063108NICHD NIH HHS U10 HD063114NIGMS NIH HHS R01 GM108618NIGMS NIH HHS R01GM108618
6 · The paper itself

Abstract

purposeSepsis causes significant worldwide morbidity and mortality. Inability to clear an infection and secondary infections are known complications in severe sepsis and likely result in worsened outcomes. We sought to characterize risk factors of these complications.

methodsWe performed a secondary analysis of clinical data from 401 subjects enrolled in the PHENOtyping sepsis-induced Multiple organ failure Study. We examined factors associated with prolonged infection, defined as infection that continued to be identified 7 days or more from initial identification, and secondary infection, defined as new infections identified ≥ 3 days from presentation. Multivariable adjustment was performed to examine laboratory markers of immune depression, with immunocompromised and immunocompetent subjects analyzed separately.

resultsIllness severity, immunocompromised status, invasive procedures, and site of infection were associated with secondary infection and/or prolonged infection. Persistent lymphopenia, defined as an absolute lymphocyte count (ALC) < 1000 cells/µL twice in the first five days, and persistent neutropenia, defined as absolute neutrophil count (ANC) < 1000 cells/µL twice in the first five days, were associated with secondary and prolonged infections. When adjusted in multivariable analysis, persistent lymphopenia remained associated with secondary infection in both immunocompromised (aOR = 14.19, 95% CI [2.69, 262.22] and immunocompetent subjects (aOR = 2.09, 95% CI [1.03, 4.17]). Persistent neutropenia was independently associated with secondary infection in immunocompromised subjects (aOR = 5.34, 95% CI [1.92, 15.84]). Secondary and prolonged infections were associated with worse outcomes, including death.

conclusionsLaboratory markers of immune suppression can be used to predict secondary infection. Lymphopenia is an independent risk factor in immunocompromised and immunocompetent patients for secondary infection.

Indexed as

CoinfectionSepsisAdolescentChildChild, PreschoolFemaleHumansImmunocompromised HostInfantLymphopeniaMaleRisk FactorsLymphopeniaNeutropeniaProlonged infectionSecondary infectionSepsis

Identifiers

PMID39117931
PMCPMC12110537

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.