Bloodstream infections at a tertiary level paediatric hospital in South Africa

Abstract

BackgroundBloodstream infection (BSI) in children causes significant morbidity and mortality. There are few studies describing the epidemiology of BSI in South African children.MethodsA retrospective descriptive cohort study was conducted at a paediatric referral hospital in Cape Town, South Africa. The National Health Laboratory Service (NHLS) microbiology database was accessed to identify positive blood culture specimens during the period 2011–2012. Demographic and clinical details, antimicrobial management and patient outcome information were extracted from medical and laboratory records. Antibiotic susceptibility results of identified organisms were obtained from the NHLS database.ResultsOf the 693 unique bacterial and fungal BSI episodes identified during the study period, 248 (35.8%) were community-acquired (CA), 371 (53.5%) hospital-acquired (HA) and 74 (10.7%) healthcare-associated (HCA). The overall risk was 6.7 BSI episodes per 1000 admissions. Escherichia coli, Staphylococcus aureus and Streptococcus pneumoniae were the most frequent causes of CA-BSI and Klebsiella pneumoniae, Acinetobacter baumanii and S.aureus were most commonly isolated in HA-BSI. On multivariable analysis, severe underweight, severe anaemia at the time of BSI, admission in the ICU at the time of BSI, and requiring ICU admission after BSI was diagnosed were significantly associated with 14-day mortality.ConclusionThis study adds to the limited literature describing BSI in children in Africa. Further studies are required to understand the impact that BSI has on the paediatric population in sub-Saharan Africa.

Neutrophil Lymphocytes Ratio as a Predictor of Bacteremia In Children

“…[15] Research in Africa said that the most bacteria found in the study were Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia and Acinetobacter baumanii. [16] The bacteria found in this study were in line with the ve largest bacteria in our study, the 5 most germs only had a sequence different. Possibly caused by the two studies carried out in developing countries, with the type of bacteria that circulates similarly.…”

Under-five children’s Bacterial Blood Stream Infection in Southern Ethiopia

“…Jimma 8.8% [8], Addis Ababa 32.8% [9] and other African countries like Tanzania 14.2% [10]; 24% [11], Gabon 17% [12], Burkina Faso 6% [13]in S. Africa 5.5% [14]; 5.7% [5]andamong Iranian neonates 6.4% [15]. Our results are comparable to study done inGondar, northern Ethiopia (39.5.9%) [16].…”

“…Regarding isolate, the current studyhas foundthat almost 43% of the isolates were CoNS and S. aureusfollowed byKlebsiella 21.4% which is similarwith other studies in Ethiopia, in Arsi [20] and Gondar [16] also with most of other studies in Africa.When we look report from African study, BSI study on neonatal in Tanzania reported that S. aureus 36.5% and Klebsiella 29.7% dominate all isolates recognized [21]there is also agreementwith report from S. Africa wereS. aureus, Klebsiella and E. coliare predominant isolate BSI among children [5]. Type of isolates in this study is still similar to that reported in other African studies for instant report from S. Africa shows predominate isolates S. aureus, Klebsiella [14]amongblood cultured samples of children.…”

“…Fevermay bethe only manifestation of childhood invasive infection. Nevertheless in Ethiopia with the added burden of malaria, HIV infection, tuberculosis and malnutrition, the treatment of fever is often syndromic, targeting multiple possible aetiologies, without necessarily considering BSI as a potential cause [5]. That is why in developing countrylike Ethiopia, where malaria is endemic, most febrile children misleadingly managed as malarial infection and only very little proportion of them empirically managed as bacterial infection.…”

Pseudomonas Aeruginosa Bloodstream Infection at A Tertiary Referral Hospital For Children

“…Fifteen (16.5%) of the children had underlying chronic illnesses other than HIV infection, that was present for at least 6 weeks duration. Eleven children had malignancies, namely, acute lymphoblastic leukaemia (3), acute myeloid leukaemia (2), lymphoma (1), neuroblastoma (1), craniopharyngioma (1) and germ cell tumour (1). Other chronic diseases included chronic lung disease (2), Fanconi anaemia (1) and aplastic anaemia (1).…”