title: Bacterial sepsis in patients with visceral leishmaniasis in Northwest Ethiopia.
abstract: OBJECTIVE
  Visceral leishmaniasis (VL) is one of the neglected diseases affecting the poorest segment of world populations. Sepsis is one of the predictors for death of patients with VL. This study aimed to assess the prevalence and factors associated with bacterial sepsis, causative agents, and their antimicrobial susceptibility patterns among patients with VL.
  
  
  METHODS
  A cross-sectional study was conducted among parasitologically confirmed VL patients suspected of sepsis admitted to the University of Gondar Hospital, Northwest Ethiopia, from February 2012 to May 2012. Blood cultures and other clinical samples were collected and cultured following the standard procedures.
  
  
  RESULTS
  Among 83 sepsis suspected VL patients 16 (19.3%) had culture confirmed bacterial sepsis. The most frequently isolated organism was Staphylococcus aureus (68.8%; 11/16), including two methicillin-resistant isolates (MRSA). Patients with focal bacterial infection were more likely to have bacterial sepsis (P < 0.001).
  
  
  CONCLUSIONS
  The prevalence of culture confirmed bacterial sepsis was high, predominantly due to S. aureus. Concurrent focal bacterial infection was associated with bacterial sepsis, suggesting that focal infections could serve as sources for bacterial sepsis among VL patients. Careful clinical evaluation for focal infections and prompt initiation of empiric antibiotic treatment appears warranted in VL patients.
authors.affiliation: Department of Medical Microbiology, University of Gondar, Ethiopia.
authors.forename: Mengistu
authors.identifier: 0000-0003-4417-2085
authors.initials: M
authors.lastname: Endris
authors.affiliation: Leishmaniasis Research and Treatment Center, University of Gondar Hospital, Ethiopia.
authors.forename: Yegnasew
authors.initials: Y
authors.lastname: Takele
authors.affiliation: Department of Immunology and Molecular Biology, University of Gondar, Ethiopia ; Department of Public Health, Addis Ababa Science and Technology University, Ethiopia.
authors.forename: Desalegn
authors.initials: D
authors.lastname: Woldeyohannes
authors.affiliation: Department of Medical Microbiology, University of Gondar, Ethiopia.
authors.forename: Moges
authors.initials: M
authors.lastname: Tiruneh
authors.affiliation: Leishmaniasis Research and Treatment Center, University of Gondar Hospital, Ethiopia.
authors.forename: Rezika
authors.initials: R
authors.lastname: Mohammed
authors.affiliation: Department of Medical Microbiology, University of Gondar, Ethiopia.
authors.forename: Feleke
authors.identifier: 0000-0002-0084-3599
authors.initials: F
authors.lastname: Moges
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Lutgarde
authors.initials: L
authors.lastname: Lynen
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Jan
authors.identifier: 0000-0002-8657-6777
authors.initials: J
authors.lastname: Jacobs
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: van Griensven
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium ; Department of Internal Medicine, University of Gondar, Ethiopia.
authors.forename: Ermias
authors.identifier: 0000-0002-3595-6323
authors.initials: E
authors.lastname: Diro
mesh_terms: D000328:Adult; D017677:Age Distribution; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000706:statistics & numerical data*; D019353:Endemic Diseases / Q000706:statistics & numerical data*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D058069:Neglected Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D017678:Sex Distribution; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult