A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy. NLM AIDSLINE Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

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A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy.

J Infect Dis. 2000 Apr;181(4):1414-20. Unique Identifier : AIDSLINE MED/20227765
Archibald LK; McDonald LC; Nwanyanwu O; Kazembe P; Dobbie H; Tokars J; Reller LB; Jarvis WR; Hospital Infections Program, Centers for Disease Control and; Prevention, Atlanta, GA 30333, USA. lca6@cdc.gov

Abstract: The etiology of bloodstream infections (BSIs) in febrile (> or =37.5 degrees C) adults (> or =18 years old) in one Malawi hospital were determined during August and September 1997. After clinical evaluation, blood was drawn for comprehensive culture, human immunodeficiency virus (HIV) type 1 testing, and malaria smear. Of 233 patients, 173 (74%) were HIV-1 infected, and 70 (30%) had BSI. BSI pathogens included 25 (33%) Streptococcus pneumoniae and 21 (28%) Mycobacterium tuberculosis. Nine patients (4%) had malaria parasitemia. BSIs were more likely in HIV-1-positive than in -negative patients (62/173 vs. 8/60, P<.01). Clinical predictors of BSI included HIV-1 infection and altered mental status. Mortality among inpatients with BSI was higher than among those without BSI (P<.001). In conclusion, S. pneumoniae and M. tuberculosis are frequent causes of BSI in febrile adults. Similar surveys, performed periodically in developing countries, may assist in the identification of clinical predictors of BSI and in planning appropriate therapy.

Keywords: JOURNAL ARTICLE Adolescence Adult Cohort Studies Female Fever/EPIDEMIOLOGY/*ETIOLOGY Hospitalization Human HIV Infections/COMPLICATIONS/DIAGNOSIS HIV-1 Malaria/COMPLICATIONS/DIAGNOSIS/EPIDEMIOLOGY Malawi/EPIDEMIOLOGY Male Middle Age Prevalence Prospective Studies Septicemia/COMPLICATIONS/*DIAGNOSIS/THERAPY Streptococcal Infections/COMPLICATIONS/DIAGNOSIS Streptococcus pneumoniae Tuberculosis/COMPLICATIONS/DIAGNOSIS

KWDjournalarticleadolescenceadultcohortstudiesfemalefever/epidemiology/KWDetiologyhospitalizationhumanhivinfections/complications/diagnosishiv-1malaria/complications/diagnosis/epidemiologymalawi/epidemiologymalemiddleageprevalenceprospectivestudiessepticemia/complications/KWDdiagnosis/therapystreptococcalinfections/complications/diagnosisstreptococcuspneumoniaetuberculosis/complications/diagnosis
000830
A0080951

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