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Clinical presentation of non-typhoidal Salmonella bacteraemia in Malawian children
We report the clinical presentation and outcome of 299 Malawian children with non-typhoidal Salmonella (NTS) bacteraemia and no evidence of focal sepsis, admitted to Queen Elizabeth Central Hospital (QECH), Blantyre, over a 26-month period (February 1996–April 1998). A peak incidence during the rain...
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Published in: | Transactions of the Royal Society of Tropical Medicine and Hygiene 2000-05, Vol.94 (3), p.310-314 |
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Main Authors: | , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | We report the clinical presentation and outcome of 299 Malawian children with non-typhoidal
Salmonella (NTS) bacteraemia and no evidence of focal sepsis, admitted to Queen Elizabeth Central Hospital (QECH), Blantyre, over a 26-month period (February 1996–April 1998). A peak incidence during the rainy season was noted.
Salmonella typhimurium (79%) and
S. enteritidis (13%) were the commonest isolates. For children aged >6 months, NTS bacteraemia was significantly associated with malarial parasitaemia (RR 1·5 [1·2, 2·2],
P < 0·01) and with severe anaemia (RR 7·2 [3·4, 15·3],
P < 0·0001), when compared to other common pathogens causing childhood bacteraemia. Clinical overlap with malaria and anaemia, and the presence of malarial parasitaemia on admission, may delay diagnosis. NTS bacteraemia was commonly diagnosed following blood transfusion. Resistance
in vitro to ampicillin (79%), co-trimoxazole (72%) and gentamicin (55%) was very common, and was rare to chloramphenicol (0·3%) which is the antibiotic of choice for NTS sepsis at QECH. Overall mortality was high (23%). Young age and clinical HIV infection were risk factors for mortality. Recurrences of NTS bacteraemia following antibiotic therapy were common among children with clinical HIV infection. |
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ISSN: | 0035-9203 1878-3503 |
DOI: | 10.1016/S0035-9203(00)90337-7 |