Bacteraemia complicating severe malaria in children
Bacteraemia complicating severe malaria in children
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DOI：
10.1016/s0035-9203(99)90024-x
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发表时间：
1999-05-01
影响因子：
2.2
通讯作者：
Marsh, K
中科院分区：
文献类型：
--
作者：
Berkley, J;Mwarumba, S;Marsh, K
与儿童严重疟疾相关的菌血症是一种零星报道的现象，但其发病率和临床重要性尚不清楚。我们回顾了783名肯尼亚儿童的临床和实验室数据，这些儿童被初步诊断为严重疟疾。重度疟疾儿童菌血症的总体发生率为7.8%（95% CI 5.5-10.0）;然而，30个月以下儿童的发生率为12.0%（95% CI 8.3-15.7）。菌血症的存在与死亡率增加3倍相关（33.3%对10.4%，P < 0.001）。我们的结论是，侵入性细菌性疾病可能有助于严重疟疾的临床综合征的一个重要的儿童亚组的病理生理。我们建议患有严重疟疾的幼儿除抗疟药物外，还应使用广谱抗生素进行治疗。
Bacteraemia associated with severe malaria in childhood is a sporadically reported phenomenon but its incidence and clinical importance are unknown. We have reviewed clinical and laboratory data from 783 Kenyan children sequentially admitted with a primary diagnosis of severe malaria. The overall incidence of bacteraemia in children with severe malaria was 7.8% (95% CI 5.5-10.0); however, in children under 30 months of age the incidence was 12.0% (95% CI 8.3-15.7). The presence of bacteraemia was associated with a 3-fold increase in mortality (33.3% vs. 10.4%, P < 0.001). We conclude that invasive bacterial disease may contribute to the pathophysiology of the clinical syndrome of severe malaria in an important subgroup of children. We recommend that young children with severe malaria be treated with broad-spectrum antibiotics in addition to antimalarial drugs.