title: Bacteraemia in malnourished rural African children.
abstract: During a 5-month study period, 323 of 863 (37.5%) children below 5 years of age admitted to Shongwe Mission Hospital in rural South Africa were malnourished, two-thirds severely so. The incidence of bacteraemia in malnourished children was 9.6%, 11.8% in those severely malnourished and 5.8% in nutritional dwarfs. The predominant organisms retrieved were Gram-negative enteric bacilli (48.5%). Amongst the severely malnourished, who empirically receive intravenous ampicillin and gentamicin, 95.8% of all isolates were sensitive to this antibiotic combination. The case fatality rate of severely malnourished bacteraemic children was 20.8%. In malnutrition categories overall, the case fatality rate for bacteraemic children (22.6%) was significantly greater than in those without bacteraemia (9.3%). In hospitals with limited resources, full identification of bacteria may not be necessary, provided that regular surveillance for emerging resistance is conducted.
authors.affiliation: Shongwe Mission Hospital, University of the Witwatersrand, Johannesburg, Republic of South Africa.
authors.forename: R P
authors.initials: RP
authors.lastname: Reed
authors.forename: F O
authors.initials: FO
authors.lastname: Wegerhoff
authors.forename: A D
authors.initials: AD
authors.lastname: Rothberg
mesh_terms: D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D002675:Child, Preschool; D015331:Cohort Studies; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009748:Nutrition Disorders / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D012424:Rural Population; D013019:South Africa / Q000453:epidemiology; D015996:Survival Rate
chemical_list: D000900:Anti-Bacterial Agents