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Bacteraemia among severely malnourished children infected and uninfected with the human immunodeficiency virus-1 in Kampala, Uganda

Bergen Open Research Archive

Show simple item record Bachou, Hanifa Tylleskär, Thorkild Kaddu-Mulindwa, Deogratias H. Tumwine, James K. 2006-11-24T15:46:17Z 2006-11-24T15:46:17Z 2006-11-07
dc.identifier.issn 1471-2334
dc.description.abstract Background: To establish the magnitude of bacteraemia in severely malnourished children, and describe the types of bacteria and antimicrobial sensitivity by HIV status. Method: Isolates were recovered from 76 blood specimens. Antibiotic susceptibility tests were performed using commercial antibiotic disks and demographic and clinical findings were recorded. Results: Of the 450 children 63% were male; median age 17.0 months (inter quartile range, IQR 12–24) and 57% had oedema. 151 (36.7 %) of 411 tested HIV-positive; 76 (17.1%) of 445 blood specimens grew bacterial isolates; 58% were Gram negative – S. typhimurium (27.6%) and S. enteriditis (11.8%). Staph. aureus (26.3%) and Strep. pneumoniae (13.2%) were the main Gram positive organisms. There was no difference in the risk of bacteraemia by HIV status, age < 24 months, male sex, or oedema, except for oral thrush (OR 2.3 CI 1.0–5.1) and hypoalbuminaemia (OR 3.5 CI 1.0–12.1). Isolates from severely immuno-suppressed children (CD4% <15%) were more likely to grow Salmonella enteriditis (OR 5.4; CI 1.6 – 17.4). The isolates were susceptible (≥ 80%) to ciprofloxacin, ceftriaxone and gentamicin; with low susceptibility to chlorampenicol, ampicillin (< 50%) and co-trimoxazole (<25%). Suspicion of bacteraemia had 95.9% sensitivity and 99.2% specificity. Among bacteraemic children, mortality was higher (43.5% vs 20.5%) in the HIV-positive; OR 3.0 (95%CI 1.0, 8.6). Conclusion: Bacteraemia affects 1 in every 6 severely malnourished children and carries high mortality especially among the HIV-positive. Given the high level of resistance to common antibiotics, there is need for clinical trials to determine the best combinations of antibiotics for management of bacteraemia in severely malnourished children. en
dc.format.extent 258958 bytes
dc.format.mimetype application/pdf
dc.language.iso eng en
dc.publisher BioMed Central en
dc.rights Copyright 2006 Bachou et al; licensee BioMed Central Ltd. en
dc.title Bacteraemia among severely malnourished children infected and uninfected with the human immunodeficiency virus-1 in Kampala, Uganda en
dc.type Journal article en
dc.subject.nsi VDP::Medisinske Fag: 700::Helsefag: 800 no
dc.subject.nsi VDP::Matematikk og Naturvitenskap: 400::Basale biofag: 470::Generell mikrobiologi: 472 no
dc.type.version publishedVersion
bora.peerreviewed Peer reviewed
bora.journalTitle BMC Infectious Diseases
bibo.volume 6
bora.cristinID 377306
bibo.number 160

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