Community-acquired septicaemia in southern Viet Nam: the importance of multidrug-resistant Salmonella typhi.
In a prospective study conducted between mid 1993 and 1994, 437 adults and children were admitted with community-acquired septicaemia to an infectious diseases hospital in southern Viet Nam. Gram-negative aerobes accounted for 90% of isolates and were predominantly Salmonella typhi (67%), Sal. para-typhi A (3%), Escherichia coli (10%), and Klebsiella spp. (5%). Other Salmonella spp. (1%), Pseudomonas aeruginosa (1%), Neisseria meningitidis (0.5%) and Haemophilus influenzae (0.2%) were uncommon. Staphylococcus aureus (5.5%) and Streptococcus pneumoniae (2%) were the most common Gram-positive isolates. Patients with enteric fever were younger (median age 16 years, range 1-63) than the other patients (median age 43 years, range 1-88) (P < 0.001) and had a lower mortality rate (0.3% vs. 23%; relative risk 69.5, 95% confidence interval 9.5-507.8; P < 0.0001). Over 70% of the Sal. typhi isolated were multi-drug-resistant, and 4% were resistant to nalidixic acid. Multidrug-resistant Sal. typhi is a major cause of community-acquired septicaemia in Viet Nam.
Hoa
N T
NT
Centre for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Viet Nam.
Diep
T S
TS
Wain
J
J
Parry
C M
CM
Hien
T T
TT
Smith
M D
MD
Walsh
A L
AL
White
N J
NJ
D000293:Adolescent; D000328:Adult; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012485:Salmonella typhi; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology*; D014435:Typhoid Fever / Q000382:microbiology*; D014504:Urban Health / Q000706:statistics & numerical data; D014744:Vietnam / Q000453:epidemiology