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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Bacteraemia in patients admitted to an urban hospital in West Africa
BMC Infectious Diseases, Volume 7, Article 2, Year 2007
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Description
Background: Few studies on bacteraemia in Africa have been published. We aimed to prospectively identify the causative organisms of bacteraemia in The Gambia and their relation to clinical diagnoses, outcome and antimicrobial susceptibility. Methods: Between November 2003 and February 2005 we studied those admitted to the Medical Research Council hospital who were suspected of having bacteraemia. We documented clinical features, outcome, pathogens identified and their susceptibility patterns, and searched for factors associated with bacteraemia. Results: 871 patients were admitted and had a blood culture taken. The median age was 2 years (range 2 months to 80 years) and 36 of 119 tested were HIV positive; 54.5% were male. 297 (34%) had a positive result and 93 (10.7% overall) were considered a genuine pathogen. Those with bacteraemia were more likely to die in hospital (OR 2.79; 1.17-6.65, p = 0.017) and to have a high white cell count (WCC; OR 1.81;95% CI 1.09-3.02; p = 0.022). Three organisms accounted for 73% of bacteraemias: Streptococcus pneumoniae (45.2%), Staphylococcus aureus (18.3%) and Escherichia coli (9.7%) while non-typhoidal salmonellae (NTS) accounted for 8.6%. Antimicrobial susceptibility of S. pneumoniae was very high to penicillin (97.5%); high resistance was found to co-trimoxazole. S. aureus was generally highly susceptible to cloxacillin, gentamicin and chloramphenicol. E. coli and NTS were all susceptible to ciprofloxacin and mostly susceptible to gentamicin. Thirteen (33%) S. pneumoniae isolates were of serotypes contained in a 7-valent pneumococcal conjugate vaccine and 20 (51.3%) were of the same serogroup. Conclusion: In The Gambia, those with bacteraemia are more likely than those without to die in hospital and to have a raised peripheral blood WCC. S. pneumoniae is the most common organism isolated. Introduction of a pneumococcal conjugate vaccine can be expected to lead to a reduction in disease incidence. © 2007 Hill et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Hill, Philip C.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Onyeama, Charles O.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Ikumapayi, Usman Nurudeen A.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Secka, Ousman O.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Ameyaw, Samuel K.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Simmonds, Naomi
United Kingdom, London
Ucl Medical School
Donkor, Simon A.
Unknown Affiliation
Howie, Stephen R.C.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Tapgun, Mary
Gambia, Banjul
Medical Research Council Laboratories Gambia
Corrah, Tumani P.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Adegbola, Richard A.
Gambia, Banjul
Medical Research Council Laboratories Gambia
Statistics
Citations: 88
Authors: 11
Affiliations: 2
Identifiers
Doi:
10.1186/1471-2334-7-2
e-ISSN:
14712334
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
Multi-countries
Gambia
Participants Gender
Male