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Community acquired bacteremia in young children from central Nigeria--a pilot study.

Obaro S, Lawson L, Essen U, Ibrahim K, Brooks K, Otuneye A, Shetima D, Ahmed P, Ajose T, Olugbile M, Idiong D, Ogundeji D, Ochigbo C, Olanipekun G, Khalife W, Adegbola R - BMC Infect. Dis. (2011)

Bottom Line: S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting.This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children.Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.

View Article: PubMed Central - HTML - PubMed

Affiliation: Michigan State University, East Lansing, MI 48824, USA. Stephen.obaro@hc.msu.edu

ABSTRACT

Background: Reports of the etiology of bacteremia in children from Nigeria are sparse and have been confounded by wide spread non-prescription antibiotic use and suboptimal laboratory culture techniques. We aimed to determine causative agents and underlying predisposing conditions of bacteremia in Nigerian children using data arising during the introduction of an automated blood culture system accessed by 7 hospitals and clinics in the Abuja area.

Methods: Between September 2008 and November 2009, we enrolled children with clinically suspected bacteremia at rural and urban clinical facilities in Abuja or within the Federal Capital Territory of Nigeria. Blood was cultured using an automated system with antibiotic removing device. We documented clinical features in all children and tested for prior antibiotic use in a random sample of sera from children from each site.

Results: 969 children aged 2 months-5 years were evaluated. Mean age was 21±15.2 months. All children were not systematically screened but there were 59 (6%) children with established diagnosis of sickle cell disease and 42 (4.3%) with HIV infection. Overall, 212 (20.7%) had a positive blood culture but in only 105 (10.8%) were these considered to be clinically significant. Three agents, Staphylococcus aureus (20.9%), Salmonella typhi (20.9%) and Acinetobacter (12.3%) accounted for over half of the positive cultures. Streptococcus pneumoniae and non-typhi Salmonellae each accounted for 7.6%. Although not the leading cause of bacteremia, Streptococcus pneumoniae was the single leading cause of all deaths that occurred during hospitalization and after hospital discharge.

Conclusion: S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting. This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children. Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.

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Related in: MedlinePlus

Antimicrobial Activity in Serum by site of Enrolment.
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Figure 2: Antimicrobial Activity in Serum by site of Enrolment.

Mentions: Approximately 10% of samples from each enrollment site were randomly selected for testing. Prevalence of serum antimicrobial activity was highest in children who presented to the National Hospital (88.9%), the major tertiary referral center in Abuja and was lowest in those who presented to Zankli Medical Center (40%) and Nyanya General Hospital (45%). Data summarized in Figure 2.


Community acquired bacteremia in young children from central Nigeria--a pilot study.

Obaro S, Lawson L, Essen U, Ibrahim K, Brooks K, Otuneye A, Shetima D, Ahmed P, Ajose T, Olugbile M, Idiong D, Ogundeji D, Ochigbo C, Olanipekun G, Khalife W, Adegbola R - BMC Infect. Dis. (2011)

Antimicrobial Activity in Serum by site of Enrolment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3111365&req=5

Figure 2: Antimicrobial Activity in Serum by site of Enrolment.
Mentions: Approximately 10% of samples from each enrollment site were randomly selected for testing. Prevalence of serum antimicrobial activity was highest in children who presented to the National Hospital (88.9%), the major tertiary referral center in Abuja and was lowest in those who presented to Zankli Medical Center (40%) and Nyanya General Hospital (45%). Data summarized in Figure 2.

Bottom Line: S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting.This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children.Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.

View Article: PubMed Central - HTML - PubMed

Affiliation: Michigan State University, East Lansing, MI 48824, USA. Stephen.obaro@hc.msu.edu

ABSTRACT

Background: Reports of the etiology of bacteremia in children from Nigeria are sparse and have been confounded by wide spread non-prescription antibiotic use and suboptimal laboratory culture techniques. We aimed to determine causative agents and underlying predisposing conditions of bacteremia in Nigerian children using data arising during the introduction of an automated blood culture system accessed by 7 hospitals and clinics in the Abuja area.

Methods: Between September 2008 and November 2009, we enrolled children with clinically suspected bacteremia at rural and urban clinical facilities in Abuja or within the Federal Capital Territory of Nigeria. Blood was cultured using an automated system with antibiotic removing device. We documented clinical features in all children and tested for prior antibiotic use in a random sample of sera from children from each site.

Results: 969 children aged 2 months-5 years were evaluated. Mean age was 21±15.2 months. All children were not systematically screened but there were 59 (6%) children with established diagnosis of sickle cell disease and 42 (4.3%) with HIV infection. Overall, 212 (20.7%) had a positive blood culture but in only 105 (10.8%) were these considered to be clinically significant. Three agents, Staphylococcus aureus (20.9%), Salmonella typhi (20.9%) and Acinetobacter (12.3%) accounted for over half of the positive cultures. Streptococcus pneumoniae and non-typhi Salmonellae each accounted for 7.6%. Although not the leading cause of bacteremia, Streptococcus pneumoniae was the single leading cause of all deaths that occurred during hospitalization and after hospital discharge.

Conclusion: S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting. This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children. Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.

Show MeSH
Related in: MedlinePlus