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Community-acquired bacteraemia in African children

par Lepage, Philippe ;Van Goethem, Christiaan;Ntahorutaba, Mélanie;Nsengumuremyia, François;Hitimana, Déo Gratias;Bogaerts, Jos;Vandepitte, Joseph;Butzler, Jean-Paul ;Levy, Jack
Référence Lancet, 1, 8548, page (1458-1461)
Publication Publié, 1987

Article révisé par les pairs

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Résumé :

To examine the frequency of community acquired bacteraemia in children in Kigali, Rwanda, blood cultures were obtained from 900 consecutive febrile children (T° ≥ 39°C) seen at an outpatient clinic over the course of a year. A pathogen was isolated from 112 children (12.4%): Salmonella typhi from 47, S. enteritidis from 23, S. typhimirium from 13, Streptococcus pneumoniae from 14, Staphylococcus aureus from 9, and Haemophilus influenzae from 3. Salmonella species represented 74% of the isolates. The children with S. typhi bacteraemia were older (mean age 75 months) than those with bacteraemia due to other organisms. Controls consisted of febrile, non-bacteraemic children without (group I) or with (group II) Plasmodium falciparum parasitaemia. Bacteraemic children were older and presented more frequently with diarrhoea, vomiting, and dehydration, but less frequently with convulsions than controls. The rate of hospital admission was higher among bacteraemic children (61%) than among group I (39%) or group II (46%) controls. The case-fatality rate was similar in the three groups (9.3% versus 2.9% and 7.3%). Community-acquired bacteraemia in Rwandese childen is common and is mainly caused by Salmonella species.