Causes of community-acquired bacteremia and patterns of antimicrobial resistance in Vientiane, Laos.
There is no published information on the causes of bacteremia in the Lao PDR (Laos). Between 2000 and 2004, 4512 blood culture pairs were taken from patients admitted to Mahosot Hospital, Vientiane, Laos, with suspected community-acquired bacteremia; 483 (10.7%) cultures grew a clinically significant community-acquired organism, most commonly Salmonella enterica serovar typhi (50.9%), Staphylococcus aureus (19.0%), and Escherichia coli (12.4%). S. aureus bacteremia was common among infants (69.2%), while children 1-5 years had a high frequency of typhoid (44%). Multi-drug-resistant S. Typhi was rare (6%). On multiple logistic regression analysis, typhoid was associated with younger age, longer illness, diarrhea, higher admission temperature, and lower peripheral white blood cell count than non-typhoidal bacteremia. Empirical parenteral ampicillin and gentamicin would have some activity against approximately 88% of clinically significant isolates at a cost of US $1.4/day, an important exception being B. pseudomallei. Bacteremic infants in this setting require an anti-staphylococcal antibiotic.
Phetsouvanh
Rattanaphone
R
Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR.
Phongmany
Simmaly
S
Soukaloun
Douangdao
D
Rasachak
Bouachanh
B
Soukhaseum
Vimone
V
Soukhaseum
Seun
S
Frichithavong
Kamthavi
K
Khounnorath
Sengmanivong
S
Pengdee
Bounthom
B
Phiasakha
Khamphong
K
Chu
Vang
V
Luangxay
Khonesavanh
K
Rattanavong
Sayadeth
S
Sisouk
Konkam
K
Keolouangkot
Valy
V
Mayxay
Mayfong
M
Ramsay
Andrew
A
Blacksell
Stuart D
SD
Campbell
Jim
J
Martinez-Aussel
Bertrand
B
Heuanvongsy
Mayboun
M
Bounxouei
Bounthapaany
B
Thammavong
Chanpheng
C
Syhavong
Bounkong
B
Strobel
Michel
M
Peacock
Sharon J
SJ
White
Nicholas J
NJ
Newton
Paul N
PN
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D001769:Blood / Q000382:microbiology; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology*; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D007812:Laos / Q000453:epidemiology
D000900:Anti-Bacterial Agents