Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

Journal of Medical Case Reports

Lawrence Osei-Tutu¹  Juergen May²  Nicole Sunaina Struck²  Denise Dekker²  Daniel Eibach²  Charity Wiafe Akenten³  Kwadwo Sarfo Marfo³  Nimako Sarpong³  Kennedy Gyau Boahen³  John Humphrey Amuasi⁴ 

[1] Agogo Presbyterian Hospital, Asante Akyem, Ghana;Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany;Kumasi Centre for Collaborative Research in Tropical Medicine, P.O Box PMB KNUST, Kumasi, Ghana;Kumasi Centre for Collaborative Research in Tropical Medicine, P.O Box PMB KNUST, Kumasi, Ghana;School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;

关键词: Malaria;    Coinfections;    Acinetobacter baumanii;    Bacteremea;    Case report;    Ghana;   

DOI  :  10.1186/s13256-020-02648-7

来源: Springer

【 摘 要 】

BackgroundThe increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment.Case presentationA 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved.ConclusionEven though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

【 授权许可】

CC BY