• Sebastian Born, Christof Dame, Claudia Matthäus-Krämer, Luregn J Schlapbach, Felix Reichert, Anna Schettler, Daniel Schwarzkopf, Daniel Thomas-Rüddel, Hans Proquitté, Konrad Reinhart, and Carolin Fleischmann-Struzek.
• Center for Sepsis Control and Care, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
• Crit. Care Med. 2021 Jul 1; 49 (7): 104910571049-1057.

ObjectivesWorldwide, more than half of all sepsis cases occur in pediatric and adolescent patients, particularly in neonates. Previous population-based studies in these age groups often were limited to either neonatal or pediatric patients admitted to ICUs. We aimed to investigate the overall and age-specific incidence and case fatality of sepsis in children in Germany, a high-income country with a total population of 82 million.DesignRetrospective observational study based on the German Diagnosis-related Groups statistics of the years 2010-2016.SettingAll acute care hospitals in Germany except for prison and psychiatric hospitals.PatientsPediatric patients less than or equal to 19 years with International Classification of Diseases, 10th Revision-coded sepsis, neonates with International Classification of Diseases, 10th Revision-coded neonatal sepsis.InterventionsNone.Measurements And Main ResultsWe analyzed pediatric sepsis incidence in patients aged birth to less than or equal to 19 years old, case fatality, and underlying comorbidities, and neonatal sepsis incidence and case fatality within the neonatal period. We identified 14,635 pediatric sepsis cases among 15.4 million pediatric hospitalizations between 2010 and 2016 (= 0.1% of pediatric hospitalizations). The incidence of pediatric sepsis was 14 cases per 100,000 children between 0 and 19 years. Case fatality was 16.6% and decreased from 17.8% (2010) to 15.0% (2016). A total of 11.5% of hospital deaths in the age group 0-19 years were associated with pediatric sepsis. Sepsis incidence and case fatality were highest in children less than 1 year old and declined in older children and adolescents. Admissions with pediatric sepsis were more common in children with preexisting comorbidities compared with those without (0.52% vs 0.03% of pediatric admissions). In neonates, the incidence of neonatal sepsis was 1,006 cases per 100,000 live births. Case fatality was 3.9%. While 17.7% of very low birth weight infants had neonatal sepsis, only 2.1% of low birth weight and 0.6% of normal birth weight neonates were affected, respectively.ConclusionsSepsis is also in Germany a common and frequently fatal condition in pediatric patients, particularly among neonates and children with comorbidities.Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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