Community-Acquired Bacteremia Among Children Admitted to a Rural Hospital in Mozambique

Sigaùque, Betuel; Roca, Anna; Mandomando, Inácio; Morais, Luís; Quintó, Llorenç; Sacarlal, Jahit; Macete, Eusébio; Nhamposa, Tacilta; Machevo, Sónia; Aíde, Pedro; Bassat, Quique; Bardají, Azucena; Nhalungo, Delino; Soriano‐Gabarró, Montse; Flannery, Brendan; Menéndez, Clara; Levine, Myron M.; Alonso, Pedro L.

doi:10.1097/inf.0b013e318187a87d

Cited by 216 publications

(289 citation statements)

References 29 publications

Supporting

Mentioning

263

Contrasting

Order By: Relevance

“…NTS bacteremia most commonly occurs in African children younger than 2 y of age (1,2,17), and we found a relative sparing of infants younger than 4 months of age in Malawi (18). This period coincides with the loss of maternal antibody and lack of production of antibody by the child's own immune system.…”

mentioning

confidence: 92%

Importance of antibody and complement for oxidative burst and killing of invasive nontyphoidalSalmonellaby blood cells in Africans

Gondwe

Molyneux

Goodall

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

121

133

View full text Add to dashboard Cite

Bacteremia caused by nontyphoidal strains of Salmonella is endemic among African children. Case-fatality rates are high and antibiotic resistance increasing, but no vaccine is currently available. T cells are important for clearance of Salmonella infection within macrophages, but in Africa, invasive Salmonella disease usually manifests in the blood and affects children between 4 months and 2 y of age, when anti- Salmonella antibody is absent. We have previously found a role for complement-fixing bactericidal antibody in protecting these children. Here we show that opsonic activity of antibody and complement is required for oxidative burst and killing of Salmonella by blood cells in Africans. Induction of neutrophil oxidative burst correlated with anti- Salmonella IgG and IgM titers and C3 deposition on bacteria and was significantly lower in African children younger than 2 y compared with older children. Preopsonizing Salmonella with immune serum overcame this deficit, indicating a requirement for antibody and/or complement. Using different opsonization procedures, both antibody and complement were found to be necessary for optimal oxidative burst, phagocytosis and killing of nontyphoidal Salmonella by peripheral blood cells in Africans. Although most strains of African nontyphoidal Salmonella can be killed with antibody and complement alone, phagocytes in the presence of specific antibody and complement can kill strains resistant to killing by immune serum. These findings increase the likelihood that an antibody-inducing vaccine will protect against invasive nontyphoidal Salmonella disease in African children.

show abstract

mentioning

confidence: 92%

Importance of antibody and complement for oxidative burst and killing of invasive nontyphoidalSalmonellaby blood cells in Africans

Gondwe

Molyneux

Goodall

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

121

133

View full text Add to dashboard Cite

show abstract

“…3 These isolates were tested for antibiotic susceptibility. The proportion of non-susceptible isolates to the antibiotics commonly used in this setting is shown in Table 1 .…”

Section: Antimicrobial Drug Susceptibilitymentioning

confidence: 99%

“…However, there little data are available to monitor antibiotic resistance [16][17][18][19] and support national treatment guidelines. Within a large prospective study designed to characterize the etiology of bacteremia in children admitted to a rural district hospital, 3 we have been able to monitor antibiotic resistance over a five-year period. We analyzed the antimicrobial susceptibility patterns of bloodstream isolates and their time trends for the five most frequent etiologies of bacteremia found in this setting.…”

Section: Introductionmentioning

confidence: 99%

“…1 Invasive bacterial infections are major contributors to this excess mortality among children. 2,3 Non-typhi Salmonella (NTS), Streptococcus pneumoniae , Staphylococcus aureus, Escherichia coli , and Haemophilus influenzae have been consistently described as the principal bacteremia etiologies among children in sub-Saharan Africa. [2][3][4][5][6] There is a growing concern regarding management of community-acquired infections in Africa because of increas ing prevalence of resistance to the most commonly antibiotics used in these settings, and the emergence of multidrug-resistant strains.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Non-typhi Salmonella (NTS), Streptococcus pneumoniae , Staphylococcus aureus, Escherichia coli , and Haemophilus influenzae have been consistently described as the principal bacteremia etiologies among children in sub-Saharan Africa. [2][3][4][5][6] There is a growing concern regarding management of community-acquired infections in Africa because of increas ing prevalence of resistance to the most commonly antibiotics used in these settings, and the emergence of multidrug-resistant strains. [6][7][8][9][10][11] Factors such as indiscriminate use of antibiotics as growth promoters in veterinary medicine, antibiotic dispensation without prescription, or incomplete compliance to prescribed duration of treatment are among the major contributors for the global increase of resistance.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Antimicrobial Drug Resistance Trends of Bacteremia Isolates in a Rural Hospital in Southern Mozambique

Mandomando¹,

Sigaùque²,

Morais³

et al. 2010

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

Antibiotic resistance in Africa is increasing but insufficiently recognized as a public health problem. However, there are scarce data for antimicrobial resistance trends among bloodstream isolates in sub-Saharan Africa. Antimicrobial drug resistance trends among bacteria isolated from blood of children < 15 years of age admitted to the Manhiça District Hospital in Mozambique during May 2001–April 2006 were monitored by disk diffusion. We documented a linear trend of increasing resistance throughout the study period to chloramphenicol among isolates of Non-typhi Salmonella (P < 0.001), Escherichia coli (P = 0.002), Staphylococcus aureus (P < 0.001), and Haemophilus influenzae (P < 0.001). Increasing resistance to ampicillin was also observed for H. influenzae isolates (P < 0.001). We report trends of increasing resistance among the most frequent etiologies of bacteremia to the most commonly used antibiotics for empirical therapy in this community. Quinolones and third-generation cephalosporines may be needed in the short term to manage community-acquired infections.

show abstract

Epidemiology and management of group B streptococcal colonization during pregnancy in Africa

Capan

Mombo-Ngoma

Akerey-Diop

et al. 2012

Wien Klin Wochenschr

View full text Add to dashboard Cite

Group B streptococcal infections are a leading cause of neonatal morbidity and mortality. Maternal microbiological screening during pregnancy and intrapartum antimicrobial treatment of maternal group B streptococcus (GBS) colonization constitutes an effective prevention strategy to reduce early neonatal invasive disease due to GBS in the European and North American setting. Data on the prevalence of GBS colonization in pregnancy and incidence of neonatal invasive GBS disease are very limited for low-income regions. However, the first reports from sub-Saharan Africa indicate that GBS colonization rates may be comparable to industrialized countries and that related neonatal morbidity and mortality is of significance. Prior to the development of suitable prevention strategies, which are undoubtedly needed in resource poor settings, more evidence on GBS epidemiology in sub-Saharan Africa and assessment of cost effectiveness of different prevention strategies are essential.

show abstract

Community-Acquired Bacteremia Among Children Admitted to a Rural Hospital in Mozambique

Abstract: Community-acquired bacteremia is an important cause of pediatric hospital admission and death in rural African hospitals. The high burden of disease, mortality, and pattern of antibiotic resistance associated with bacteremia underscore the need for prevention in Sub-Saharan Africa.

Cited by 216 publications

References 29 publications

Importance of antibody and complement for oxidative burst and killing of invasive nontyphoidalSalmonellaby blood cells in Africans

Importance of antibody and complement for oxidative burst and killing of invasive nontyphoidalSalmonellaby blood cells in Africans

Antimicrobial Drug Resistance Trends of Bacteremia Isolates in a Rural Hospital in Southern Mozambique

Epidemiology and management of group B streptococcal colonization during pregnancy in Africa

Contact Info

Product

Resources

About