Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review.
Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review.
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DOI：
10.1186/1741-7015-12-31
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发表时间：
2014-02-19
期刊：
影响因子：
9.3
通讯作者：
Maitland K
中科院分区：
文献类型：
--
作者：
Church J;Maitland K
严重疟疾仍然是非洲儿童入院的主要原因。侵袭性细菌感染（IBI）是恶性疟原虫疟疾的一种公认的并发症，会导致严重恶化的结果。疟疾感染与 IBI 易感性之间是否存在生物学关系仍不清楚。因此，我们研究了这种关联的程度、性质和证据。 2012 年 8 月，我们对三个主要科学数据库（PubMed、Embase 和 Africa Wide Information）进行了系统检索，查找描述恶性疟原虫疟疾儿童细菌感染的文章，使用搜索字符串“（疟疾或疟原虫）AND（细菌或细菌或菌血症或菌血症或败血症或败血症或败血症）”。资格标准还包括对撒哈拉以南地区因疟疾住院或门诊就诊的儿童的研究非洲。 11 个非洲国家的总共 25 项研究符合我们的标准。它们包括二十项队列分析、两项随机对照试验和三项前瞻性流行病学研究。在对 7,208 名严重疟疾儿童的荟萃分析中，IBI 的平均患病率为 6.4%（95% 置信区间 (CI) 5.81 至 6.98%）。对 20,889 名因全严重疟疾住院的儿童和 27,641 名非疟疾发热性疾病儿童进行的进一步荟萃分析显示，疟疾儿童 IBI 平均患病率为 5.58（95% CI 5.5 - 5.66%），非疟疾儿童 IBI 平均患病率为 7.77%（95% CI 7.72 - 7.83%）。十项研究报告了按 IBI 分层的死亡率。疟疾/IBI 双重感染儿童中，336 名儿童中有 81 名病死，死亡率为 24.1%（95% CI 18.9 - 29.4），而单独感染疟疾的儿童为 5,760 名，死亡率为 585 名，死亡率为 10.2%（95% CI 9.3 - 10.98）。肠道革兰氏阴性菌在疟疾病例中比例过高，其中非伤寒沙门氏菌是最常见的分离株。有微弱的证据表明 IBI 在严重疟疾的严重贫血表现中更为常见。积累的证据表明，最近患有或急性疟疾的儿童面临细菌感染的风险，从而导致死亡风险增加。由于缺乏适当的严重性匹配对照和异构数据，描述这种关联的确切性质具有挑战性。需要进一步研究来确定风险最大的人群，以针对抗菌治疗。
Severe malaria remains a major cause of pediatric hospital admission across Africa. Invasive bacterial infection (IBI) is a recognized complication of Plasmodium falciparum malaria, resulting in a substantially worse outcome. Whether a biological relationship exists between malaria infection and IBI susceptibility remains unclear. We, therefore, examined the extent, nature and evidence of this association. We conducted a systematic search in August 2012 of three major scientific databases, PubMed, Embase and Africa Wide Information, for articles describing bacterial infection among children with P. falciparum malaria using the search string ‘(malaria OR plasmodium) AND (bacteria OR bacterial OR bacteremia OR bacteraemia OR sepsis OR septicaemia OR septicemia).’ Eligiblity criteria also included studies of children hospitalized with malaria or outpatient attendances in sub-Saharan Africa. A total of 25 studies across 11 African countries fulfilled our criteria. They comprised twenty cohort analyses, two randomized controlled trials and three prospective epidemiological studies. In the meta-analysis of 7,208 children with severe malaria the mean prevalence of IBI was 6.4% (95% confidence interval (CI) 5.81 to 6.98%). In a further meta-analysis of 20,889 children hospitalised with all-severity malaria and 27,641 children with non-malarial febrile illness the mean prevalence of IBI was 5.58 (95% CI 5.5 to 5.66%) in children with malaria and 7.77% (95% CI 7.72 to 7.83%) in non-malaria illness. Ten studies reported mortality stratified by IBI. Case fatality was higher at 81 of 336, 24.1% (95% CI 18.9 to 29.4) in children with malaria/IBI co-infection compared to 585 of 5,760, 10.2% (95% CI 9.3 to 10.98) with malaria alone. Enteric gram-negative organisms were over-represented in malaria cases, non-typhoidal Salmonellae being the most commonest isolate. There was weak evidence indicating IBI was more common in the severe anemia manifestation of severe malaria. The accumulated evidence suggests that children with recent or acute malaria are at risk of bacterial infection, which results in an increased risk of mortality. Characterising the exact nature of this association is challenging due to the paucity of appropriate severity-matched controls and the heterogeneous data. Further research to define those at greatest risk is necessary to target antimicrobial treatment.
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DOI：
10.1016/s1201-9712(01)90067-0
发表时间：
2001-01-01
期刊：
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
影响因子：
--
作者：
Bahwere, P;Levy, J;De Mol, P
通讯作者：
De Mol, P
DOI：
10.1016/s0035-9203(99)90024-x
发表时间：
1999-05-01
影响因子：
2.2
作者：
Berkley, J;Mwarumba, S;Marsh, K
通讯作者：
Marsh, K
影响因子：
168.9
作者：
Dondorp, Arjen M.;Fanello, Caterina I.;White, Nicholas J.
通讯作者：
White, Nicholas J.
影响因子：
82.9
作者：
通讯作者：
--
DOI：
10.1086/600299
发表时间：
2009-08-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Berkley JA;Bejon P;Mwangi T;Gwer S;Maitland K;Williams TN;Mohammed S;Osier F;Kinyanjui S;Fegan G;Lowe BS;English M;Peshu N;Marsh K;Newton CR
通讯作者：
Newton CR