Document Detail

Bacteraemia in malnourished rural African children.
MedLine Citation:
PMID:  8787368     Owner:  NLM     Status:  MEDLINE    
During a 5-month study period, 323 of 863 (37.5%) children below 5 years of age admitted to Shongwe Mission Hospital in rural South Africa were malnourished, two-thirds severely so. The incidence of bacteraemia in malnourished children was 9.6%, 11.8% in those severely malnourished and 5.8% in nutritional dwarfs. The predominant organisms retrieved were Gram-negative enteric bacilli (48.5%). Amongst the severely malnourished, who empirically receive intravenous ampicillin and gentamicin, 95.8% of all isolates were sensitive to this antibiotic combination. The case fatality rate of severely malnourished bacteraemic children was 20.8%. In malnutrition categories overall, the case fatality rate for bacteraemic children (22.6%) was significantly greater than in those without bacteraemia (9.3%). In hospitals with limited resources, full identification of bacteria may not be necessary, provided that regular surveillance for emerging resistance is conducted.
There are an estimated 170 million children in the world who are malnourished, 20 million severely. The authors determined the prevalence of bacteremia in malnourished children admitted to Shongwe Mission Hospital, documented the effect of bacteremia upon mortality, and provide a basis for antimicrobial use in malnourished children with suspected bacteremia. 323 of 863 children under age 5 years admitted to the hospital between May 23 and October 22, 1992, were malnourished, 66% severely. There was a 9.6% prevalence of bacteremia in malnourished children, 11.8% in those severely malnourished, and 5.8% in nutritional dwarfs. Gram-negative enteric bacilli were retrieved in 48.5% of cases. 95.8% of all isolates among the severely malnourished children were sensitive to the combination of intravenous ampicillin and gentamicin. There was a 20.8% case fatality rate among severely malnourished bacteremic children. In malnutrition categories overall, the case fatality rate for bacteremic children (22.6%) was significantly greater than in those without bacteremia (9.3%). The authors note that it may not be necessary to fully identify bacteria in hospitals with limited resources as long as regular surveillance for emerging resistance is conducted.
R P Reed; F O Wegerhoff; A D Rothberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of tropical paediatrics     Volume:  16     ISSN:  0272-4936     ISO Abbreviation:  Ann Trop Paediatr     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-09-26     Completed Date:  1996-09-26     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8210625     Medline TA:  Ann Trop Paediatr     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  61-8     Citation Subset:  IM; J    
Shongwe Mission Hospital, University of the Witwatersrand, Johannesburg, Republic of South Africa.
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MeSH Terms
Anti-Bacterial Agents
Bacteremia / complications,  drug therapy,  epidemiology*
Child, Preschool
Cohort Studies
Drug Therapy, Combination / therapeutic use
Gram-Negative Bacteria / drug effects,  isolation & purification
Gram-Positive Bacteria / drug effects,  isolation & purification
Infant, Newborn
Nutrition Disorders / complications,  epidemiology*,  therapy
Retrospective Studies
Rural Population
South Africa / epidemiology
Survival Rate
Reg. No./Substance:
0/Anti-Bacterial Agents

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