title: Causes of community-acquired bacteremia and patterns of antimicrobial resistance in Vientiane, Laos.
abstract: 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.
authors.affiliation: Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR.
authors.forename: Rattanaphone
authors.initials: R
authors.lastname: Phetsouvanh
authors.forename: Simmaly
authors.initials: S
authors.lastname: Phongmany
authors.forename: Douangdao
authors.initials: D
authors.lastname: Soukaloun
authors.forename: Bouachanh
authors.initials: B
authors.lastname: Rasachak
authors.forename: Vimone
authors.initials: V
authors.lastname: Soukhaseum
authors.forename: Seun
authors.initials: S
authors.lastname: Soukhaseum
authors.forename: Kamthavi
authors.initials: K
authors.lastname: Frichithavong
authors.forename: Sengmanivong
authors.initials: S
authors.lastname: Khounnorath
authors.forename: Bounthom
authors.initials: B
authors.lastname: Pengdee
authors.forename: Khamphong
authors.initials: K
authors.lastname: Phiasakha
authors.forename: Vang
authors.initials: V
authors.lastname: Chu
authors.forename: Khonesavanh
authors.initials: K
authors.lastname: Luangxay
authors.forename: Sayadeth
authors.initials: S
authors.lastname: Rattanavong
authors.forename: Konkam
authors.initials: K
authors.lastname: Sisouk
authors.forename: Valy
authors.initials: V
authors.lastname: Keolouangkot
authors.forename: Mayfong
authors.initials: M
authors.lastname: Mayxay
authors.forename: Andrew
authors.initials: A
authors.lastname: Ramsay
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Blacksell
authors.forename: Jim
authors.initials: J
authors.lastname: Campbell
authors.forename: Bertrand
authors.initials: B
authors.lastname: Martinez-Aussel
authors.forename: Mayboun
authors.initials: M
authors.lastname: Heuanvongsy
authors.forename: Bounthapaany
authors.initials: B
authors.lastname: Bounxouei
authors.forename: Chanpheng
authors.initials: C
authors.lastname: Thammavong
authors.forename: Bounkong
authors.initials: B
authors.lastname: Syhavong
authors.forename: Michel
authors.initials: M
authors.lastname: Strobel
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Peacock
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: White
authors.forename: Paul N
authors.initials: PN
authors.lastname: Newton
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents