title: Septicaemia in Hong Kong.
abstract: In a five-year prospective study of blood culture-positive septicaemia in a Hong Kong teaching hospital there were 2211 clinically-significant episodes, of which 16% occurred in children less than 15 years old. The microbiology and clinical features were broadly similar to those seen in Europe and North America, but with some important differences. Two-thirds of episodes were community-acquired. The most common organism isolated from community-acquired septicaemias was Escherichia coli and the source, most commonly, the urinary tract. However, the biliary tract was the second most common source of community-acquired infection (25%), reflecting the frequency of liver disease in Hong Kong. Three per cent of community-acquired septicaemias were associated with endocarditis; half of these were with viridans streptococci, usually in patients with rheumatic heart disease, and 40% were in drug addicts with methicillin-sensitive Staphylococcus aureus. The commonest organisms causing community-acquired childhood infections were Salmonella spp. (27%) and Streptococcus pneumoniae (22%), whereas pneumococci accounted for only 3% of adult community-acquired micro-organisms. Haemophilus influenzae infections were uncommon and there was no case of meningococcal or gonococcal septicaemia. The commonest cause of hospital-acquired septicaemia was Staph. aureus (24%), of which 46% were methicillin-resistant. The characteristics of septicaemia in Hong Kong are influenced by the patient population structure, endemic disease patterns, local medical practice and socio-economic factors, but the rarity of Str. pneumoniae in adults and of H. influenzae and Neisseria meningitidis in children is unexplained.
authors.affiliation: Department of Microbiology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories.
authors.forename: G L
authors.initials: GL
authors.lastname: French
authors.forename: A F
authors.initials: AF
authors.lastname: Cheng
authors.forename: R
authors.initials: R
authors.lastname: Duthie
authors.forename: C S
authors.initials: CS
authors.lastname: Cockram
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D005658:Fungi / Q000302:isolation & purification; D006088:Gram-Negative Aerobic Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006723:Hong Kong / Q000453:epidemiology; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology