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Multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest Nigeria

Pediatric community-acquired bloodstream infections (CA-BSIs) in sub Saharan African humanitarian contexts are rarely documented. Effective treatment of these infections is additionally complicated by increasing rates of antimicrobial resistance. We describe the findings from epidemiological and mic...

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Autores principales: Chukwumeze, Frederick, Lenglet, Annick, Olubiyo, Ruth, Lawal, Abdulhakeem Mohammed, Oluyide, Bukola, Oloruntuyi, Gbemisola, Ariti, Cono, Gomez, Diana, Roggeveen, Harriet, Nwankwo, Chijioke, Augustine, Nwogu Ahamba, Egwuenu, Abiodun, Maloba, Guy, Sherlock, Mark, Muhammad, Shoaib, Wertheim, Heiman, Hopman, Joost, Clezy, Kate
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531324/
https://www.ncbi.nlm.nih.gov/pubmed/34675262
http://dx.doi.org/10.1038/s41598-021-00149-1
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author Chukwumeze, Frederick
Lenglet, Annick
Olubiyo, Ruth
Lawal, Abdulhakeem Mohammed
Oluyide, Bukola
Oloruntuyi, Gbemisola
Ariti, Cono
Gomez, Diana
Roggeveen, Harriet
Nwankwo, Chijioke
Augustine, Nwogu Ahamba
Egwuenu, Abiodun
Maloba, Guy
Sherlock, Mark
Muhammad, Shoaib
Wertheim, Heiman
Hopman, Joost
Clezy, Kate
author_facet Chukwumeze, Frederick
Lenglet, Annick
Olubiyo, Ruth
Lawal, Abdulhakeem Mohammed
Oluyide, Bukola
Oloruntuyi, Gbemisola
Ariti, Cono
Gomez, Diana
Roggeveen, Harriet
Nwankwo, Chijioke
Augustine, Nwogu Ahamba
Egwuenu, Abiodun
Maloba, Guy
Sherlock, Mark
Muhammad, Shoaib
Wertheim, Heiman
Hopman, Joost
Clezy, Kate
author_sort Chukwumeze, Frederick
collection PubMed
description Pediatric community-acquired bloodstream infections (CA-BSIs) in sub Saharan African humanitarian contexts are rarely documented. Effective treatment of these infections is additionally complicated by increasing rates of antimicrobial resistance. We describe the findings from epidemiological and microbiological surveillance implemented in pediatric patients with suspected CA-BSIs presenting for care at a secondary hospital in the conflict affected area of Zamfara state, Nigeria. Any child (> 2 months of age) presenting to Anka General Hospital from November 2018 to August 2020 with clinical severe sepsis at admission had clinical and epidemiological information and a blood culture collected at admission. Bacterial isolates were tested for antibiotic susceptibility. We calculated frequencies of epidemiological, microbiological and clinical parameters. We explored risk factors for death amongst severe sepsis cases using univariable and multivariable Poisson regression, adjusting for time between admission and hospital exit. We included 234 severe sepsis patients with 195 blood culture results. There were 39 positive blood cultures. Of the bacterial isolates, 14 were Gram positive and 18 were Gram negative; 5 were resistant to empiric antibiotics: methicillin-resistant Staphylococcus aureus (MRSA; n = 2) and Extended Spectrum Beta-Lactamase positive enterobacterales (n = 3). We identified no significant association between sex, age-group, ward, CA-BSI, appropriate intravenous antibiotic, malaria positivity at admission, suspected focus of sepsis, clinical severity and death in the multivariable regression. There is an urgent need for access to good clinical microbiological services, including point of care methods, and awareness and practice around rational antibiotic in healthcare staff in humanitarian settings to reduce morbidity and mortality from sepsis in children.
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spelling pubmed-85313242021-10-22 Multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest Nigeria Chukwumeze, Frederick Lenglet, Annick Olubiyo, Ruth Lawal, Abdulhakeem Mohammed Oluyide, Bukola Oloruntuyi, Gbemisola Ariti, Cono Gomez, Diana Roggeveen, Harriet Nwankwo, Chijioke Augustine, Nwogu Ahamba Egwuenu, Abiodun Maloba, Guy Sherlock, Mark Muhammad, Shoaib Wertheim, Heiman Hopman, Joost Clezy, Kate Sci Rep Article Pediatric community-acquired bloodstream infections (CA-BSIs) in sub Saharan African humanitarian contexts are rarely documented. Effective treatment of these infections is additionally complicated by increasing rates of antimicrobial resistance. We describe the findings from epidemiological and microbiological surveillance implemented in pediatric patients with suspected CA-BSIs presenting for care at a secondary hospital in the conflict affected area of Zamfara state, Nigeria. Any child (> 2 months of age) presenting to Anka General Hospital from November 2018 to August 2020 with clinical severe sepsis at admission had clinical and epidemiological information and a blood culture collected at admission. Bacterial isolates were tested for antibiotic susceptibility. We calculated frequencies of epidemiological, microbiological and clinical parameters. We explored risk factors for death amongst severe sepsis cases using univariable and multivariable Poisson regression, adjusting for time between admission and hospital exit. We included 234 severe sepsis patients with 195 blood culture results. There were 39 positive blood cultures. Of the bacterial isolates, 14 were Gram positive and 18 were Gram negative; 5 were resistant to empiric antibiotics: methicillin-resistant Staphylococcus aureus (MRSA; n = 2) and Extended Spectrum Beta-Lactamase positive enterobacterales (n = 3). We identified no significant association between sex, age-group, ward, CA-BSI, appropriate intravenous antibiotic, malaria positivity at admission, suspected focus of sepsis, clinical severity and death in the multivariable regression. There is an urgent need for access to good clinical microbiological services, including point of care methods, and awareness and practice around rational antibiotic in healthcare staff in humanitarian settings to reduce morbidity and mortality from sepsis in children. Nature Publishing Group UK 2021-10-21 /pmc/articles/PMC8531324/ /pubmed/34675262 http://dx.doi.org/10.1038/s41598-021-00149-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Chukwumeze, Frederick
Lenglet, Annick
Olubiyo, Ruth
Lawal, Abdulhakeem Mohammed
Oluyide, Bukola
Oloruntuyi, Gbemisola
Ariti, Cono
Gomez, Diana
Roggeveen, Harriet
Nwankwo, Chijioke
Augustine, Nwogu Ahamba
Egwuenu, Abiodun
Maloba, Guy
Sherlock, Mark
Muhammad, Shoaib
Wertheim, Heiman
Hopman, Joost
Clezy, Kate
Multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest Nigeria
title Multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest Nigeria
title_full Multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest Nigeria
title_fullStr Multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest Nigeria
title_full_unstemmed Multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest Nigeria
title_short Multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest Nigeria
title_sort multi-drug resistance and high mortality associated with community-acquired bloodstream infections in children in conflict-affected northwest nigeria
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531324/
https://www.ncbi.nlm.nih.gov/pubmed/34675262
http://dx.doi.org/10.1038/s41598-021-00149-1
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