Risk of community- and hospital-acquired bacteremia and profile of antibiotic resistance in children hospitalized with severe acute malnutrition in Niger

International Journal of Infectious Diseases

Christopher T. Andersen¹  Souna Garba²  Nathan Sayinzonga-Makombe²  Céline Langendorf³  Sheila Isanaka³  Rebecca F. Grais³  Kerstin E. Hanson⁴  Christopher Mambula⁵  Isabelle Mouniaman⁵ 

[1] Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA;Epicentre, Niamey, Niger;Epicentre, Paris, France;Independent consultant;Médecins Sans Frontières – Operational Center Paris, Paris, France;

关键词: Antimicrobial resistance;    Bacteremia;    Community-acquired;    Hospital-acquired;    Niger;    Nosocomial;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objective: To estimate the prevalence and antibiotic resistance profile of community- and hospital-acquired bacteremia among hospitalized children with severe acute malnutrition in Niger. Methods: A descriptive, longitudinal study was conducted in an intensive nutritional rehabilitation center in Madarounfa, Niger. Children aged 6 to 59 months admitted for inpatient treatment of complicated severe acute malnutrition (n=2187) had blood specimens drawn at admission to assess prevalence of community-acquired bacteremia. Subsequent specimens were drawn per physician discretion to assess incidence of hospital-acquired bacteremia. Antibiotic susceptibility testing was performed on positive blood cultures. Results: The prevalence of community-acquired bacteremia at admission was at least 9.1% (95% confidence interval [CI]: 8.1, 10.4%), with non-typhoid Salmonella identified in over half (57.8%) of cases. The cumulative incidence of hospital-acquired bacteremia was estimated at 1.2% (95% CI: 0.8, 1.7%), among which the most common organisms were Klebsiella pneumoniae (19.4%), Acinetobacter baumannii (16.1%), Enterococcus faecalis (12.9%), and Escherichia coli (12.9%). In community-acquired bacteremia, 58% cases were resistant to amoxicillin-clavulanate; 100% of hospital-acquired bacteremia cases were resistant to amoxicillin and amoxicillin-clavulanate. Mortality risk was elevated among children with hospital-acquired bacteremia (risk ratio [RR] = 9.32) and community-acquired bacteremia (RR = 2.67). Conclusion: Bacteremia was a significant contributor to mortality. Antibiotic resistance poses a challenge to effective clinical management of severe acute malnutrition.

【 授权许可】

Unknown