PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Saul N. FaustPaediatric sepsisSchlapbach, Luregn J.a,b,cAuthor Information aPaediatric Critical Care Research Group, Child Health Research Centre, Faculty of Medicine, University of Queensland bPaediatric Intensive Care Unit, Queensland Children's Hospital, Brisbane, Australia cDepartment of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland Correspondence to Luregn J. Schlapbach, MD, FCICM, Paediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane QLD 4101, Australia. Tel: +61 7 3068 1111; e-mail: [email protected] Current Opinion in Infectious Diseases: October 2019 - Volume 32 - Issue 5 - p 497-504 doi: 10.1097/QCO.0000000000000583 Buy Metrics Abstract Purpose of review Sepsis remains among the leading causes of childhood mortality worldwide. This review serves to highlight key areas of knowledge gain and ongoing controversies pertinent to sepsis in children. Recent findings Several recent publications describe the epidemiology of paediatric sepsis, demonstrating the impact on child health in terms of mortality and morbidity, and the shortcomings of current paediatric sepsis definitions. Although emerging data support the importance of organ dysfunction as a hallmark of paediatric sepsis, the understanding of host susceptibility to sepsis and to sepsis severity remains very limited. Next-generation sequencing and host transcriptomics have the potential to provide new insights into the pathogenesis of sepsis and may enable personalized medicine approaches. Despite good observational data indicating benefit of sepsis recognition and treatment bundles, the evidence for the individual bundle components remains scarce, implying an urgent need for large trials. Summary Recent studies have demonstrated distinct epidemiological patterns pertinent to age groups, healthcare settings, and comorbidities in the era post meningococcal epidemics. Although sepsis quality improvement initiatives have led to substantial outcome improvements, there is urgency for innovative trials to reduce uncertainty around the optimal approach for the recognition and treatment of sepsis in children. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.