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

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dc.contributor.author Bachou, Hanifa eng
dc.contributor.author Tylleskär, Thorkild eng
dc.contributor.author Kaddu-Mulindwa, Deogratias H. eng
dc.contributor.author Tumwine, James K. eng
dc.date.accessioned 2006-11-24T15:46:17Z
dc.date.available 2006-11-24T15:46:17Z
dc.date.issued 2006-11-07 eng
dc.identifier.issn 1471-2334 eng
dc.identifier.uri http://hdl.handle.net/1956/1961
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 eng
dc.format.mimetype application/pdf eng
dc.language.iso eng eng
dc.publisher BioMed Central eng
dc.title Bacteraemia among severely malnourished children infected and uninfected with the human immunodeficiency virus-1 in Kampala, Uganda eng
dc.type Journal article eng
dc.subject.nsi VDP::Medisinske Fag: 700::Helsefag: 800 nob
dc.subject.nsi VDP::Matematikk og Naturvitenskap: 400::Basale biofag: 470::Generell mikrobiologi: 472 nob
dc.rights.holder Copyright 2006 Bachou et al; licensee BioMed Central Ltd.
dc.type.version publishedVersion eng
bora.peerreviewed Peer reviewed eng
bora.journalTitle BMC Infectious Diseases eng
bibo.volume 6 eng
bora.cristinID 377306 eng
bibo.number 160 eng
bibo.doi http://dx.doi.org/10.1186/1471-2334-6-160 eng
dc.identifier.cristinID 377306 eng
dc.identifier.doi http://dx.doi.org/10.1186/1471-2334-6-160


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