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Sepsis Epidemiology in Australian and New Zealand Children (SENTINEL)

Research project

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The SENTINEL study aims to describe the epidemiology of hospitalised children treated for sepsis in Australia and New Zealand. The primary objective is to describe the prevalence, resource utilization, and outcomes in hospitalised children treated for sepsis in Australia and New Zealand.

Why do we need the SENTINEL study?

Sepsis is the leading cause of early childhood death worldwide, with an estimated 4 million children dying from this final common pathway for severe infections every year(1). The burden of disease in Australia and New Zealand is unknown, including mortality, duration of hospitalisation, requirement for intensive care and organ support therapies, and long-term functional outcome in sepsis survivors. Early markers of severe disease and predictors of poor outcome in childhood sepsis are unknown.

Sepsis-related hospital costs are estimated at $4 billion per annum for children and $12 billion per annum for adults in the United States(2). The cost of hospitalisation for children with sepsis in Australia and New Zealand is unknown.

Variation in guidelines for sepsis treatment in Australia and New Zealand, and adherence to such guidelines, is unknown.

The microbiology and resistance patterns of bacterial pathogens in children treated for sepsis in Australia and New Zealand are unknown. Whether current empiric antibiotic recommendations are appropriate to cover bacterial pathogens causing sepsis in Australia and New Zealand is unknown.

The prevalence and outcomes in subgroups of vulnerable, high risk children, including those receiving cancer chemotherapy, those self identifying as of Aboriginal or Torres Strait Islander or Māori ethnicity, those with chronic medical conditions, and infants or neonates who are treated for sepsis are unknown. 

Baseline observational data is required to answer fundamental aspects of sepsis care for children in Australia and New Zealand, and to plan future interventional studies.

Defining characteristics, prevalence, severity, resource utilisation, cost, variation in care, and antimicrobial stewardship are all important and unexplored components of the paediatric sepsis research landscape that will be addressed by this study.

Aims of the study

  • Describe the microbiology, resistance patterns, antibiotic use patterns, and antimicrobial stewardship practices in hospitalised children treated for sepsis in Australia and New Zealand, including the burden of contaminated blood cultures in this population
  • Describe the management of hospitalised children treated for sepsis in Australia and New Zealand, including adherence to local guidelines and variation in care
  • Describe prevalence, resource utilization, and outcomes in sub-groups of vulnerable children who are at high risk of being treated for sepsis, including those receiving cancer chemotherapy, and those identifying as Aboriginal, Torres Strait Islander, Pascifika or Māori ethnicity, those with chronic disease, and infants or neonates
  • Describe the admission and discharge diagnoses of hospitalised children treated for sepsis (in whom the admission and discharge diagnoses may differ)
  • Describe the features of hospitalised children with discordant (non-septic) admission and discharge diagnoses
  • Identify features, including biomarkers and existing clinical scores, that identify hospitalised children treated for sepsis who are at risk of deterioration and poor outcome
  • Identify the frequency and features of hospitalised children who deteriorate within 24 hours of admission and require treatment for sepsis on hospital wards
  • Identify feasible inclusion criteria and outcomes to be used in the design and conduct of future interventional sepsis trials.