Bacteremia in hospitalized black South African children. A one-year study emphasizing nosocomial bacteremia and bacteremia in severely malnourished children
F. E. Berkowitz
During a one-year period, 315 of 5,397 children admitted to the general
pediatric wards of a hospital had bacteremia. The commonest causative
organisms were Streptococcus pneumoniae, Salmonella enteritidis, Hemophilus
influenzae, and Escherichia coli. Most episodes of bacteremia were
associated with gastroenteritis, pneumonia, or meningitis. Seventy-eight
episodes occurred in children with severe protein-energy malnutrition, and
46 episodes were hospital acquired. The overall case fatality rate was
23.2%, being highest in children with severe malnutrition and in those with
other underlying conditions. The high proportion of bacteremias due to S
pneumoniae and S enteritidis possibly reflects infections occurring in a
lower socioeconomic group living in a temperate climate in crowded
conditions. The most appropriate antimicrobial therapy for children who
have suspected bacteremia in association with gastroenteritis or severe
malnutrition is a combination of ampicillin sodium and gentamicin sulfate.
