Community-acquired bacteremia among hospitalized children in rural Central Africa

Abstract

Community-acquired bacteremia caused by multiresistant Enterobacteriacea is an important problem of hospitalized well-nourished and malnourished children in central Africa. Fever on admission is a sensitive diagnostic sign, even in malnourished children.

Bacteremia among Children Admitted to a Rural Hospital in Kenya

“…3,4,7,[9][10][11] We found only three cases of Neisseria meningitidis and one case of Salmonella typhi bacteremia. H. influenzae type b conjugate vaccination was introduced in the final eight months of the study.…”

“…2 However, there are almost no estimates of incidence, mortality, or hospital burden for the majority of pathogenic bacterial species. Most data are from a few urban referral centers, [3][4][5][6][7][8][9] with very little recent data from the rural areas 10,11 where most people in sub-Saharan Africa live. Thus, the impact of childhood bacteremia is largely unknown.…”

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

“…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.…”

“…[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. Intrinsic factors related to the appearance of antimicrobial drug resistance also take into account diverse molecular mechanisms of resistance, including the presence of plasmids or integrons carrying genetic determinants of resistance.…”

Invasive multidrug-resistant non-typhoidal Salmonella infections in Africa: zoonotic or anthroponotic transmission?

“…In all sub-Saharan African countries where they have been studied, NTS are the commonest or second-commonest cause of bacteraemia in children under 5 years of age (Bahwere et al, 2001;Berkley et al, 2005;Graham, 2002;Green & Cheesbrough, 1993;Lepage et al, 1990). They are also the second-commonest cause of neonatal meningitis, the third-most-common cause of bacterial meningitis in children over 2 months of age in Malawi (Molyneux et al, 2003), and an important cause of septic arthritis (Lepage et al, 1990) and neonatal sepsis (Milledge et al, 2005).…”