Bacteremia caused by multidrug-resistant bacteria among hospitalized malnourished children in Mwanza, Tanzania: a cross sectional study
| Autor: | Adolfine Hokororo, Stephen E. Mshana, Martha F. Mushi, Maimuna Ahmed, Mariam M. Mirambo |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Pediatrics Population Short Report Ceftazidime Bacteremia medicine.disease_cause Child Nutrition Disorders Tanzania General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Drug Resistance Multiple Bacterial 030225 pediatrics Ampicillin Clavulanic acid Internal medicine Streptococcus pneumoniae Humans Medicine 030212 general & internal medicine education Medicine(all) education.field_of_study Bacteria Biochemistry Genetics and Molecular Biology(all) business.industry General Medicine Amoxicillin medicine.disease Hospitalization Cross-Sectional Studies Child Preschool Ceftriaxone business medicine.drug |
| Zdroj: | BMC Research Notes |
| ISSN: | 1756-0500 |
| DOI: | 10.1186/s13104-017-2389-z |
| Popis: | Background Severe malnutrition has been known to increase susceptibility and severity of infections. Bacteremia in malnourished children has been found to increase morbidity and mortality especially if is due to multidrug resistant bacteria. Here, we report the prevalence of bacteremia among children under 5 years of age and the antibiotic susceptibility pattern of the isolates; the information that can be used by clinicians to guide on the empirical antibiotic treatment. Findings A total of 402 malnourished children were investigated for bacteremia. The median age of enrolled children were 17 (IQR 12–31) months. Severe malnutrition was observed in 19.1% of malnourished underfives. The point prevalence of bacteremia among malnourished children was 56/402 (13.9%; 95% CI 10.3–17.3). The prevalence of bacteremia was significantly higher among severely malnourished children than in children with moderate/mild malnutrition (18.0 vs. 10.7%, P = 0.03). Mortality was significantly associated with bacteremia among severely malnourished children (OR 2.77, 95% CI 1.02–6.98, P = 0.02). Pseudomonas spp. 20/56 (35.7%) were the most frequent isolates while Staphylococcus aureus and Streptococcus pneumoniae were isolated in 8/56 (14.2%) and 5/56 (8.9%) respectively. Rates of resistance for gram negative bacteria were; ampicillin (100%), amoxicillin/clavulanic acid (85.7%), gentamicin (23.8%), ceftriaxone (23.8%), ceftazidime (23.8%) meropenem (4.7%) and ciprofloxacin (2.4%). methicillin resistant S. aureus strains were confirmed in 4/8 (50%) of S. aureus isolates and 60% of S. pneumoniae isolates were resistant to 1 µg oxacillin. Conclusion Bacteremia due to multi drug resistant isolates is common among severely malnourished children under 5 years of age. There is a need to review empirical antibiotic treatment coupled with antibiotic stewardship to prevent mortality and morbidity of severely malnourished children under 5 years of age. |
| Databáze: | OpenAIRE |
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