1. CAUSES OF COMMUNITY-ACQUIRED BACTEREMIA AND PATTERNS OF ANTIMICROBIAL RESISTANCE IN VIENTIANE, LAOS
- Author
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Bertrand Martinez-Aussel, Valy Keolouangkot, Bounthapaany Bounxouei, Konkam Sisouk, Sayadeth Rattanavong, Stuart D. Blacksell, Michel Strobel, Vang Chu, Nicholas J. White, James Campbell, Simmaly Phongmany, Seun Soukhaseum, Sengmanivong Khounnorath, Kamthavi Frichithavong, Bounthom Pengdee, Khonesavanh Luangxay, Sharon J. Peacock, Vimone Soukhaseum, Paul N. Newton, Khamphong Phiasakha, Mayboun Heuanvongsy, Andrew Ramsay, Bounkong Syhavong, Bouachanh Rasachak, Mayfong Mayxay, Douangdao Soukaloun, Rattanaphone Phetsouvanh, and Chanpheng Thammavong
- Subjects
medicine.medical_specialty ,Bacteremia ,Gram-Positive Bacteria ,medicine.disease_cause ,Article ,Typhoid fever ,Microbiology ,Antibiotic resistance ,Virology ,Internal medicine ,Ampicillin ,Drug Resistance, Bacterial ,Gram-Negative Bacteria ,medicine ,Humans ,Blood culture ,medicine.diagnostic_test ,business.industry ,bacterial infections and mycoses ,medicine.disease ,Anti-Bacterial Agents ,Community-Acquired Infections ,Diarrhea ,Blood ,Infectious Diseases ,Laos ,Staphylococcus aureus ,Child, Preschool ,Parasitology ,Gentamicin ,medicine.symptom ,business ,medicine.drug - Abstract
There is no published information on the causes of bacteremia in the Lao PDR (Laos). Between 2000 and 2004, 4512 blood culture pairs were taken from patients admitted to Mahosot Hospital, Vientiane, Laos, with suspected community-acquired bacteremia; 483 (10.7%) cultures grew a clinically significant community-acquired organism, most commonly Salmonella enterica serovar typhi (50.9%), Staphylococcus aureus (19.0%), and Escherichia coli (12.4%). S. aureus bacteremia was common among infants (69.2%), while children 1-5 years had a high frequency of typhoid (44%). Multi-drug-resistant S. Typhi was rare (6%). On multiple logistic regression analysis, typhoid was associated with younger age, longer illness, diarrhea, higher admission temperature, and lower peripheral white blood cell count than non-typhoidal bacteremia. Empirical parenteral ampicillin and gentamicin would have some activity against approximately 88% of clinically significant isolates at a cost of US $1.4/day, an important exception being B. pseudomallei. Bacteremic infants in this setting require an anti-staphylococcal antibiotic.
- Published
- 2006
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