The Pediatric Infectious Disease Journal. 28(2):108-113, FEBRUARY 2009

DOI: 10.1097/INF.0b013e318187a87d

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PMID: 19131902

Issn Print: 0891-3668

Publication Date: February 2009


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

Betuel Sigaúque;Anna Roca;Inácio Mandomando;Luís Morais;Llorenç Quintó;Jahit Sacarlal;Eusébio Macete;Tacilta Nhamposa;Sónia Machevo;Pedro Aide;Quique Bassat;Azucena Bardají;Delino Nhalungo;Montse Soriano-Gabarró;Brendan Flannery;Clara Menendez;Myron Levine;Pedro Alonso;

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Abstract

Background:Although community-acquired bacteremia is an important cause of childhood mortality in Africa, recognition of disease burden and potential impact of bacterial vaccines is limited.Methods:Blood cultures for bacterial pathogens were conducted systematically among children <15 years of age admitted to Manhiça District Hospital, from 2001 to 2006.Results:Blood-stream infections were identified in 8% (1550/19,896) of pediatric hospital admissions. Nontyphoidal Salmonella (NTS) and Pneumococcus were the most prevalent pathogens isolated (26% and 25% of 1550 cases, respectively). Until 28 days of life, Staphylococcus aureus (39%) and group B Streptococcus (20%) predominated. Incidence of community-acquired bacteremia per 100,000 child-years was 1730/105 in children <1 year old, 782/105 in 1–4 year oldd, and 49/105 in children 5 years and older. Case-fatality of bacteremia was 12%. Community-acquired bacteremia associated mortality accounted for 21% (162/788) of hospital deaths. Resistance to antibiotics commonly used in Mozambique was high among invasive isolates of Haemophilus influenzae, Escherichia coli, and NTS.Conclusions: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.

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