The clinical implications of ABO blood groups in Pseudomonas aeruginosa sepsis in children.

BACKGROUND Pseudomonas aeruginosa (P. aeruginosa) sepsis is a fetal disease with rapid progressive shock for infants and children in hospital and in the community, without initial treatment with appropriate antibiotics. Because underlying risk factors remain unclear for affected patients, it is still difficult for early diagnosis and therapy. Recently, ABO blood group antigens were associated with several infectious diseases. However, it was not reported whether the ABO blood group could be the clinical implications for pediatric Pseudomonas sepsis. METHODS This study retrospectively reviewed the medical records of 23 infants and children with P. aeruginosa sepsis, who were hospitalized at Kaohsiung Chang Gung Memorial Hospital from 2003 to 2009. RESULTS Eight cases had nosocomial infections, with a higher mortality rate (50%) than 15 cases (26.7%) in the community. Thirteen patients (86.7%) with community-acquired sepsis were infants, significantly younger than the nosocomial cases. ABO blood group antigens were known in 21 cases and B phenotype was the most significant. In the community-acquired group, fever and diarrhea were the most prevalent symptoms on initial presentation. Moreover, pneumonitis was the most concomitant disease in fatal cases. CONCLUSION Blood group B was highly associated with pediatric P. aeruginosa sepsis. This could be a risk factor, and play an important role for the pathogenesis of P. aeruginosa sepsis. Furthermore, if a previously healthy infant with fever and diarrhea suddenly had septic presentation, P. aeruginosa infection should be considered. In addition, more intensive care could be needed for such blood group B pediatric patients, if pneumonitis was concomitant on admission for the high mortality rate.