Secondary bacteraemia in adult patients with prolonged dengue fever

Premaratna, R.; Dissanayake, Devani Sakunthala; Silva, F H D S; Dassanayake, Maya; Silva, H J de

doi:10.4038/cmj.v60i1.7165

Cited by 15 publications

(12 citation statements)

References 9 publications

(13 reference statements)

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“…Secondary bacteremia is known to occur in many patients with acute dengue, especially in those with more severe forms of clinical disease (37,38). In addition, considerably high LPS levels have been detected in patients with acute dengue infection, especially in those with plasma leakage (15, 16).…”

Section: Many Cells Such As Monocytes Mast Cells Other Leucocytes mentioning

confidence: 99%

Lipopolysaccharide acts synergistically with the dengue virus to induce monocyte production of platelet activating factor and other inflammatory mediators

et al. 2016

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Section: Many Cells Such As Monocytes Mast Cells Other Leucocytes mentioning

confidence: 99%

Lipopolysaccharide acts synergistically with the dengue virus to induce monocyte production of platelet activating factor and other inflammatory mediators

et al. 2016

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“…However, it is difficult to determine which subgroups of dengue patients have concomitant bacterial infections, and for clinicians to know which patients need what antibiotics, and when they need them. Although several studies (Chai et al , 2007; Lee et al , 2005; Premaratna et al , 2015; Thein et al , 2015) have reported the clinical characteristics and risk factors of concurrent bacteraemia in adult patients with dengue infections, none of these focused on patients with severe dengue who required admission to the ICU. Therefore, we investigated the clinical features of patients with concomitant severe dengue infection and bacteraemia, in order to identify possible risk factors for acquiring a severe dengue/bacteraemia co-infection.…”

Section: Introductionmentioning

confidence: 99%

The exploration of risk factors of concurrent bacteraemia in patients critically ill with severe dengue

Chen

Chan

Cheng

et al. 2016

Journal of Medical Microbiology

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We investigated the clinical features of intensive care unit (ICU) patients with concomitant severe dengue infection and bacteraemia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during the period of 31 July–30 November 2015 were reviewed. Patients with ‘concurrent bacteremia’ (positive bacterial blood culture within 72 h of ICU admission) were identified. ICU admission was required for 142 patients, of which 22 (15.5 %) had concurrent bacteraemia. Species of the genus Streptococcus was the most common pathogens, followed by Escherichia coli then species of the genus Staphylococcus. Patients with a severe dengue infection and bacteraemia had higher APACHE II and TISS scores, C-reactive protein (CRP) levels and leukocyte counts, positive fluid balances, longer activated partial thromboplastin times (APTTs), higher lactate levels and more kidney failure, but controls (severe dengue patients without bacteraemia) had higher Glasgow Coma Scale (GCS) scores, higher albumin levels and more abdominal pain (all P<0.05). Patients with bacteraemia had a higher mortality rate than did ontrols (40.9 vs 18.3 %; P=0.018). Multiple logistic regression analysis showed that bacteraemia was significantly positively associated with the following independent predictors: higher CRP levels [adjusted odds ratio (aOR): 1.026; 95 % confidence interval (CI): 1.008–1.044; P=0.005], and longer APTTs (aOR: 1.034; 95 CI: 1.004–1.065; P=0.027). Concurrent bacteraemia is not uncommon in severe dengue patients in the ICU, and it is associated with high mortality. Higher CRP levels and longer APTTs were two independent risk factors associated with bacteraemia.

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“…Being critically ill at presentation, comorbidities, advanced age and more severe dengue manifestations are risk factors for bacteraemia in adults 4,5 . A study in Sri Lanka showed that 25% of adult dengue patients with fever lasting more than 5 days have bacteraemia 6 . Bacterial co-infection increases the morbidity and mortality of dengue.…”

Section: Case Reportmentioning

confidence: 99%