Bacteremia in hospitalized black South African children. A one-year study emphasizing nosocomial bacteremia and bacteremia in severely malnourished children.
During a one-year period, 315 of 5,397 children admitted to the general pediatric wards of a hospital had bacteremia. The commonest causative organisms were Streptococcus pneumoniae, Salmonella enteritidis, Hemophilus influenzae, and Escherichia coli. Most episodes of bacteremia were associated with gastroenteritis, pneumonia, or meningitis. Seventy-eight episodes occurred in children with severe protein-energy malnutrition, and 46 episodes were hospital acquired. The overall case fatality rate was 23.2%, being highest in children with severe malnutrition and in those with other underlying conditions. The high proportion of bacteremias due to S pneumoniae and S enteritidis possibly reflects infections occurring in a lower socioeconomic group living in a temperate climate in crowded conditions. The most appropriate antimicrobial therapy for children who have suspected bacteremia in association with gastroenteritis or severe malnutrition is a combination of ampicillin sodium and gentamicin sulfate.
D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009748:Nutrition Disorders / Q000150:complications*; D011014:Pneumonia / Q000453:epidemiology; D012480:Salmonella Infections / Q000453:epidemiology; D012477:Salmonella enteritidis / Q000302:isolation & purification; D018805:Sepsis / Q000453:epidemiology*; D013019:South Africa; D013290:Streptococcal Infections / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification