Pediatric Sepsis in Resource-limited Settings Etiology Diagnosis, and Evidence-based Treatment Strategies

Pediatric sepsis remains a critical global health challenge and a leading cause of morbidity and mortality, particularly in neonatal and pediatric intensive care units. It is defined as life-threatening organ dysfunction resulting from a dysregulated host response to infection. This study aimed to analyze the etiology, clinical manifestations, diagnostic indicators, and modern treatment strategies of sepsis in children, with special emphasis on early recognition and evidence-based management in low- and middle-income countries, including Uzbekistan. A retrospective and analytical review of hospital-based pediatric sepsis cases and multicenter clinical studies was conducted. Epidemiological patterns, laboratory biomarkers, pathogen distribution, and therapeutic outcomes were comparatively evaluated. Particular attention was given to antimicrobial therapy timing, hemodynamic stabilization, and intensive care interventions. The findings demonstrate that early empirical antibiotic administration within the first hour significantly reduced mortality rates. Neonates and infants under one year showed the highest vulnerability and case-fatality risk. Elevated C-reactive protein, procalcitonin, and serum lactate levels were strongly associated with disease severity and progression to septic shock. Gram-negative pathogens, particularly Klebsiella pneumoniae and Escherichia coli, predominated in neonatal cases, with increasing antimicrobial resistance observed. Implementation of standardized sepsis treatment protocols improved survival outcomes and reduced hospitalization duration. In conclusion, early diagnosis, biomarker-guided risk stratification, and protocol-based management are decisive factors in improving pediatric sepsis outcomes. Strengthening intensive care capacity, laboratory diagnostics, and antimicrobial stewardship programs is essential for reducing child mortality associated with sepsis in resource-limited healthcare systems.