Skip Navigation LinksHome > March 2009 - Volume 28 - Issue 3 > Vaccine Preventable Infections and Multiple Organ Dysfunctio...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e31818a65d2
Original Studies

Vaccine Preventable Infections and Multiple Organ Dysfunction Syndrome in Critically Ill Children in China

Zhang, Qing Li MD*†‡; Wan, Chao Min MD*; MacDonald, Noni E. MD, FRCPC‡

Collapse Box


Background: Multiple organ dysfunction syndrome (MODS) is a major cause of mortality in PICUs in industrialized countries. As developing countries become more advanced, PICU care comes into reach. The aim of this study was to examine MODS in a PICU in China in comparison with other countries.

Methods: A retrospective 5-year audit (2001–2006) of MODS cases in a 6-bed PICU in the Second Hospital of Lanzhou University, China.

Results: Of the 332 PICU patients, 176 (53%) had MODS; the mean age was 35 months, and 60% were <1 year of age. Infectious diseases were the predominant factor underlying MODS (128/176; 73%) with 24% attributable to potentially vaccine preventable infections (14 to Haemophilus influenzae b, 13 to Streptococcus pneumoniae, and 4 to Neisseria meningitidis). The case fatality rate for MODS was 49% with no difference between infectious or noninfectious causes (48% vs. 52%; P > 0.05). The frequency of organ dysfunction in MODS was in decreasing order: respiratory (95%), cardiovascular (89%), gastrointestinal (39%), neurologic (35%), hematologic (16%), renal (14%), and hepatic (4%) systems. Mortality rose with increasing number of organs involved. Gastrointestinal system failure was more common in MODS caused by infection than noninfection (45% vs. 23%; P <0.01) and had a higher mortality (72% vs. 34%; P < 0.001). The case fatality rate for MODS in this study was comparable to rates in other developing countries but higher than in industrialized countries.

Conclusions: MODS is a major cause of mortality in PICU patients in China. In China, infection-related MODS PICU cases could potentially be reduced to rates closer to those in industrialized countries, if conjugated H. influenzae b and conjugated pneumococcal vaccines were introduced into routine practice.

© 2009 Lippincott Williams & Wilkins, Inc.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.