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Bacteraemia in patients admitted to an urban hospital in West Africa

BACKGROUND: Few studies on bacteraemia in Africa have been published. We aimed to prospectively identify the causative organisms of bacteraemia in The Gambia and their relation to clinical diagnoses, outcome and antimicrobial susceptibility. METHODS: Between November 2003 and February 2005 we studie...

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Autores principales: Hill, Philip C, Onyeama, Charles O, Ikumapayi, Usman NA, Secka, Ousman, Ameyaw, Samuel, Simmonds, Naomi, Donkor, Simon A, Howie, Stephen R, Tapgun, Mary, Corrah, Tumani, Adegbola, Richard A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1794245/
https://www.ncbi.nlm.nih.gov/pubmed/17257423
http://dx.doi.org/10.1186/1471-2334-7-2
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author Hill, Philip C
Onyeama, Charles O
Ikumapayi, Usman NA
Secka, Ousman
Ameyaw, Samuel
Simmonds, Naomi
Donkor, Simon A
Howie, Stephen R
Tapgun, Mary
Corrah, Tumani
Adegbola, Richard A
author_facet Hill, Philip C
Onyeama, Charles O
Ikumapayi, Usman NA
Secka, Ousman
Ameyaw, Samuel
Simmonds, Naomi
Donkor, Simon A
Howie, Stephen R
Tapgun, Mary
Corrah, Tumani
Adegbola, Richard A
author_sort Hill, Philip C
collection PubMed
description BACKGROUND: Few studies on bacteraemia in Africa have been published. We aimed to prospectively identify the causative organisms of bacteraemia in The Gambia and their relation to clinical diagnoses, outcome and antimicrobial susceptibility. METHODS: Between November 2003 and February 2005 we studied those admitted to the Medical Research Council hospital who were suspected of having bacteraemia. We documented clinical features, outcome, pathogens identified and their susceptibility patterns, and searched for factors associated with bacteraemia. RESULTS: 871 patients were admitted and had a blood culture taken. The median age was 2 years (range 2 months to 80 years) and 36 of 119 tested were HIV positive; 54.5% were male. 297 (34%) had a positive result and 93 (10.7% overall) were considered a genuine pathogen. Those with bacteraemia were more likely to die in hospital (OR 2.79; 1.17–6.65, p = 0.017) and to have a high white cell count (WCC; OR 1.81;95% CI 1.09–3.02; p = 0.022). Three organisms accounted for 73% of bacteraemias: Streptococcus pneumoniae (45.2%), Staphylococcus aureus (18.3%) and Escherichia coli (9.7%) while non-typhoidal salmonellae (NTS) accounted for 8.6%. Antimicrobial susceptibility of S. pneumoniae was very high to penicillin (97.5%); high resistance was found to co-trimoxazole. S. aureus was generally highly susceptible to cloxacillin, gentamicin and chloramphenicol. E. coli and NTS were all susceptible to ciprofloxacin and mostly susceptible to gentamicin. Thirteen (33%) S. pneumoniae isolates were of serotypes contained in a 7-valent pneumococcal conjugate vaccine and 20 (51.3%) were of the same serogroup. CONCLUSION: In The Gambia, those with bacteraemia are more likely than those without to die in hospital and to have a raised peripheral blood WCC. S. pneumoniae is the most common organism isolated. Introduction of a pneumococcal conjugate vaccine can be expected to lead to a reduction in disease incidence.
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spelling pubmed-17942452007-02-07 Bacteraemia in patients admitted to an urban hospital in West Africa Hill, Philip C Onyeama, Charles O Ikumapayi, Usman NA Secka, Ousman Ameyaw, Samuel Simmonds, Naomi Donkor, Simon A Howie, Stephen R Tapgun, Mary Corrah, Tumani Adegbola, Richard A BMC Infect Dis Research Article BACKGROUND: Few studies on bacteraemia in Africa have been published. We aimed to prospectively identify the causative organisms of bacteraemia in The Gambia and their relation to clinical diagnoses, outcome and antimicrobial susceptibility. METHODS: Between November 2003 and February 2005 we studied those admitted to the Medical Research Council hospital who were suspected of having bacteraemia. We documented clinical features, outcome, pathogens identified and their susceptibility patterns, and searched for factors associated with bacteraemia. RESULTS: 871 patients were admitted and had a blood culture taken. The median age was 2 years (range 2 months to 80 years) and 36 of 119 tested were HIV positive; 54.5% were male. 297 (34%) had a positive result and 93 (10.7% overall) were considered a genuine pathogen. Those with bacteraemia were more likely to die in hospital (OR 2.79; 1.17–6.65, p = 0.017) and to have a high white cell count (WCC; OR 1.81;95% CI 1.09–3.02; p = 0.022). Three organisms accounted for 73% of bacteraemias: Streptococcus pneumoniae (45.2%), Staphylococcus aureus (18.3%) and Escherichia coli (9.7%) while non-typhoidal salmonellae (NTS) accounted for 8.6%. Antimicrobial susceptibility of S. pneumoniae was very high to penicillin (97.5%); high resistance was found to co-trimoxazole. S. aureus was generally highly susceptible to cloxacillin, gentamicin and chloramphenicol. E. coli and NTS were all susceptible to ciprofloxacin and mostly susceptible to gentamicin. Thirteen (33%) S. pneumoniae isolates were of serotypes contained in a 7-valent pneumococcal conjugate vaccine and 20 (51.3%) were of the same serogroup. CONCLUSION: In The Gambia, those with bacteraemia are more likely than those without to die in hospital and to have a raised peripheral blood WCC. S. pneumoniae is the most common organism isolated. Introduction of a pneumococcal conjugate vaccine can be expected to lead to a reduction in disease incidence. BioMed Central 2007-01-26 /pmc/articles/PMC1794245/ /pubmed/17257423 http://dx.doi.org/10.1186/1471-2334-7-2 Text en Copyright © 2007 Hill et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hill, Philip C
Onyeama, Charles O
Ikumapayi, Usman NA
Secka, Ousman
Ameyaw, Samuel
Simmonds, Naomi
Donkor, Simon A
Howie, Stephen R
Tapgun, Mary
Corrah, Tumani
Adegbola, Richard A
Bacteraemia in patients admitted to an urban hospital in West Africa
title Bacteraemia in patients admitted to an urban hospital in West Africa
title_full Bacteraemia in patients admitted to an urban hospital in West Africa
title_fullStr Bacteraemia in patients admitted to an urban hospital in West Africa
title_full_unstemmed Bacteraemia in patients admitted to an urban hospital in West Africa
title_short Bacteraemia in patients admitted to an urban hospital in West Africa
title_sort bacteraemia in patients admitted to an urban hospital in west africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1794245/
https://www.ncbi.nlm.nih.gov/pubmed/17257423
http://dx.doi.org/10.1186/1471-2334-7-2
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