INTRODUCTION: B-cell dysfunction is a key component of immune derangement in sepsis. Follicular helper T (Tfh) cells and follicular regulatory T (Tfr) cells play critical roles in B cell maturation and differentiation. The aim of this study was to investigate whether the balance of circulating Tfh subsets (Tfh1, Tfh2, Tfh17, and Tfh17.1) and Tfr cells is altered in sepsis and evaluate their associations with B cell subsets and 28-day mortality.

CONCLUSIONS: Higher CLR and PLR and lower LHR were independently associated with both short- and long-term mortality in patients with sepsis. However, the findings were derived from a single-center retrospective cohort without independent validation and do not establish clinical prediction utility. Further multicenter studies are required to validate these markers before they can be considered for clinical risk stratification.

CONCLUSION: The random forest model showed potential for early pediatric sepsis risk stratification and warrants evaluation in an independent cohort. The Gram-stain nomogram provides exploratory findings that require external validation before clinical use. Antibiotic selection and de-escalation should be guided by microbiological evidence and comprehensive clinical assessment.

CONCLUSION: IMR is a valuable option for CRKP infections, especially in patients on CRRT. But its coverage varies by species, and it falls short in ARC patients and against non-CRKP pathogens. Dosing should be guided by species identification, susceptibility results, renal function, CRRT modality, and local resistance surveillance.