International survey on immunological diagnostics in children with sepsis.

Abstract

Background: Sepsis is a leading cause of death and disability in children and it affects in up to 50% previously healthy children who have access to health care. Undiagnosed inborn error of immunity, considered to be rare at population level, may underlie host immune dysregulation and result in exceptionally high risk for life-threatening infections.

Methods: From May 2023 to March 2024, physicians involved in the care of children with sepsis were questioned regarding their follow-up investigation practice in paediatric patients after community-acquired sepsis. This survey was distributed through three international societies.

Results: A total of 168 responses from 50 countries were analysed. The majority (82%), reported to have more than 10 years of experience. More than half (53%) stated to work in Paediatric Infectious Diseases. Major variability across respondents was observed in the approach to different scenarios of patients with sepsis. Severity of presentation, and unusual presentations increased the likelihood of ordering immunological investigations. Only 7% reported to have access to a standardised sepsis specific guideline to immunologically investigate paediatric patients after sepsis.

Conclusion: The results of this survey highlight a broad range of practices surrounding immunological investigations of children with sepsis. A consensus-based algorithm for standardised immunological and genetic testing in paediatric patients after sepsis could guide practice and inform future studies in the field.

Supplementary information: The online version contains supplementary material available at 10.1007/s44253-026-00120-w.