Bacteremia and resistant gram-negative pathogens among under-fives in Tanzania (Record no. 18888)
[ view plain ]
| 000 -LEADER | |
|---|---|
| fixed length control field | 03410nam a22001577a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
| fixed length control field | 210823b |||||||| |||| 00| 0 eng d |
| 100 ## - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Alexandra Christopher |
| 9 (RLIN) | 23226 |
| 245 ## - TITLE STATEMENT | |
| Title | Bacteremia and resistant gram-negative pathogens among under-fives in Tanzania |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Place of publication, distribution, etc. | Mwanza, Tanzania |
| Name of publisher, distributor, etc. | Catholic University of Health and Allied Sciences CUHAS - Bugando |
| Date of publication, distribution, etc. | 2013 |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Abstract<br/><br/>Background: Antibiotic resistance is one of the most serious public health concerns worldwide and is increasing at<br/>an alarming rate, making daily treatment decisions more challenging. This study is aimed at identifying local<br/>bacterial isolates and their antimicrobial susceptibility patterns to avoid irrational antibiotic use, especially in settings<br/>where unguided management occurs and febrile illnesses are predominant.<br/><br/>Material and methods: A hospital-based prospective cross-sectional study was conducted from September 2011 to<br/>February 2012. Febrile children were serially recruited and demographic and clinical data were collected using a<br/>standardized data collection tool. A blood culture was performed and identification of the isolates was undertaken using<br/>in-house biochemical tests. Susceptibility to common antibiotics was investigated using the disc diffusion methods.<br/><br/>Results: Of the 1081 children admitted during the study period, 317 (29.3%) met the inclusion criteria and were<br/>recruited, of whom 195 (61.5%) and 122 (38.5%) were male and female respectively. The median age was 18 months<br/>with an interquartile range of 9 to 36 months. Of the 317 children, 251 (79.2%) were below or equal to 36 months of<br/>age. The prevalence of bacteremia was 6.6%. A higher prevalence of bacteraemia was observed in children below<br/>36 months than in those ≥36 months (7.5% vs. 3.0%, p = 0.001). Predictors of bacteraemia were an axillary temperature<br/>of >38.5 °C (OR =7, 95% CI = 2.2 - 14.8, p-value = 0.0001), a positive malaria slide (OR =5, 95% CI = 3.0 - 21.2,<br/>p-value = 0.0001) and a high neutrophils’count (OR =21 95% CI = 5.6 - 84, p-value = 0.0001). Escherichia coli and<br/>Klebsiella pneumoniae accounted for 7 (33.3%) and 6 (28.6%) of all the isolates respectively. Others<br/>gram-negatives bacteria were Citrobacter spp 2 (9.5%), Enterobacter spp 1 (4.25%), Pseudomonas spp 2 (9.5%), Proteus<br/>spp 1 (4.25%) and Salmonella spp 1 (4.25%) . These isolates were highly resistant to ampicillin (95%), co-trimoxazole<br/>(90%), tetracycline (90%), gentamicin (80%), augmentin (80%), chloramphenicol (65%), ceftriaxone (35%), cefotaxime<br/>(35%) ciprofloxacin (30%), amikacin (30%), ceftazidime (25%) and norfloxacine (10%).<br/><br/>Conclusion: Multi-resistant gram-negative bacteria are the commonest cause of bacteremia in under-fives attending<br/>the Bugando Medical Centre, Mwanza, Tanzania. A high body temperature, a positive malaria slide and a high absolute<br/>neutrophils’count were all independent risk factors found to predict bacteremia. A higher mortality rate was observed<br/>in children with bacteraemia. Continuous epidemiological surveillance should be conducted so that a proper and<br/>effective antibiotics management can be instituted, especially in children with a high grade fever, a positive malaria<br/>slide and a high neutrophils’count. |
| 700 ## - ADDED ENTRY--PERSONAL NAME | |
| 9 (RLIN) | 15820 |
| 9 (RLIN) | 22909 |
| 9 (RLIN) | 23224 |
| 9 (RLIN) | 22989 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) | |
| Source of classification or shelving scheme | ddc |
| Koha item type | RESEARCH ARTICLES |
| Withdrawn status | Lost status | Source of classification or shelving scheme | Damaged status | Not for loan | Collection | Home library | Current library | Shelving location | Date acquired | Total checkouts | Barcode | Date last seen | Price effective from | Koha item type |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | 08/23/2021 | RA0089 | 08/23/2021 | 08/23/2021 | RESEARCH ARTICLES |