title: Community-acquired bacteremia among children admitted to a rural hospital in Mozambique.
abstract: BACKGROUND
  Although community-acquired bacteremia is an important cause of childhood mortality in Africa, recognition of disease burden and potential impact of bacterial vaccines is limited.
  
  
  METHODS
  Blood cultures for bacterial pathogens were conducted systematically among children <15 years of age admitted to Manhiça District Hospital, from 2001 to 2006.
  
  
  RESULTS
  Blood-stream infections were identified in 8% (1550/19,896) of pediatric hospital admissions. Nontyphoidal Salmonella (NTS) and Pneumococcus were the most prevalent pathogens isolated (26% and 25% of 1550 cases, respectively). Until 28 days of life, Staphylococcus aureus (39%) and group B Streptococcus (20%) predominated. Incidence of community-acquired bacteremia per 100,000 child-years was 1730/10 in children <1 year old, 782/10 in 1-4 year oldd, and 49/10 in children 5 years and older. Case-fatality of bacteremia was 12%. Community-acquired bacteremia associated mortality accounted for 21% (162/788) of hospital deaths. Resistance to antibiotics commonly used in Mozambique was high among invasive isolates of Haemophilus influenzae, Escherichia coli, and NTS.
  
  
  CONCLUSIONS
  Community-acquired bacteremia is an important cause of pediatric hospital admission and death in rural African hospitals. The high burden of disease, mortality, and pattern of antibiotic resistance associated with bacteremia underscore the need for prevention in Sub-Saharan Africa.
authors.affiliation: Centro de Investigação em Saúde da Manhiça, Maputo, Mozambique. betuel.sigauque@manhica.net
authors.forename: Betuel
authors.initials: B
authors.lastname: Sigaúque
authors.forename: Anna
authors.initials: A
authors.lastname: Roca
authors.forename: Inácio
authors.initials: I
authors.lastname: Mandomando
authors.forename: Luís
authors.initials: L
authors.lastname: Morais
authors.forename: Llorenç
authors.initials: L
authors.lastname: Quintó
authors.forename: Jahit
authors.initials: J
authors.lastname: Sacarlal
authors.forename: Eusébio
authors.initials: E
authors.lastname: Macete
authors.forename: Tacilta
authors.initials: T
authors.lastname: Nhamposa
authors.forename: Sónia
authors.initials: S
authors.lastname: Machevo
authors.forename: Pedro
authors.initials: P
authors.lastname: Aide
authors.forename: Quique
authors.initials: Q
authors.lastname: Bassat
authors.forename: Azucena
authors.initials: A
authors.lastname: Bardají
authors.forename: Delino
authors.initials: D
authors.lastname: Nhalungo
authors.forename: Montse
authors.initials: M
authors.lastname: Soriano-Gabarró
authors.forename: Brendan
authors.initials: B
authors.lastname: Flannery
authors.forename: Clara
authors.initials: C
authors.lastname: Menendez
authors.forename: Myron M
authors.initials: MM
authors.lastname: Levine
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000150:complications / Q000453:epidemiology*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications / Q000453:epidemiology; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000150:complications / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009073:Mozambique / Q000453:epidemiology; D012424:Rural Population
chemical_list: D000900:Anti-Bacterial Agents