IMPORTANCE OF ENTERIC BACTERIA AS A CAUSE OF PNEUMONIA, MENINGITIS AND SEPTICEMIA AMONG CHILDREN IN A RURAL-COMMUNITY IN THE GAMBIA, WEST-AFRICA
IMPORTANCE OF ENTERIC BACTERIA AS A CAUSE OF PNEUMONIA, MENINGITIS AND SEPTICEMIA AMONG CHILDREN IN A RURAL-COMMUNITY IN THE GAMBIA, WEST-AFRICA
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DOI：
10.1097/00006454-199402000-00009
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发表时间：
1994-02-01
影响因子：
3.6
通讯作者：
GREENWOOD, BM
中科院分区：
文献类型：
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作者：
ODEMPSEY, TJD;MCARDLE, TF;GREENWOOD, BM
在冈比亚的一个农村地区，对2,898名5岁以下的儿童进行了为期两年的肺炎、脑膜炎或败血症的调查。经临床检查和适当检查，确诊肺炎1014例，脑膜炎31例，败血症100例。977名儿童被确诊为疟疾，其中702名儿童符合世界卫生组织肺炎诊断标准。确诊为肺炎115例(11%)，脑膜炎25例(81%)，疑似败血症29例(29%)。总体而言，肺炎球菌是肺炎和脑膜炎儿童中发现的主要病原体，在败血症儿童中排名第三。然而，在疟疾传播最高的雨季，从符合世界卫生组织肺炎诊断标准的儿童身上获得的血培养菌株中，有50%是沙门氏菌或大肠菌群，而肺炎球菌和b型流感嗜血杆菌只占菌株的43%。因此，肠道细菌可能与那些在雨季出现肺炎临床图像的儿童中更常与呼吸道疾病有关的细菌一样重要。这一发现对病例管理和抗生素耐药性监测具有重要意义。
Two thousand eight hundred ninety-eight children younger than 5 years old were investigated during a 2-year period in a rural area of The Gambia for possible pneumonia, meningitis or septicemia. After clinical examination and appropriate investigations, 1014 children were diagnosed as having pneumonia, 31 as having meningitis and 100 as having septicemia. Nine hundred seven children had a final diagnosis of malaria including 702 who satisfied the World Health Organization criteria for a diagnosis of pneumonia. A bacterial etiology was established in 115 (11%) patients with a final diagnosis of pneumonia, in 25 (81%) with meningitis and in 29 (29%) with suspected septicemia. Overall the pneumococcus was the leading pathogen identified among children with pneumonia and meningitis and ranked third among those with septicemia. However, during the wet season, when malaria transmission was highest, 50% of blood culture isolates obtained from children satisfying the World Health Organization criteria for a diagnosis of pneumonia were Salmonella or coliform species, and the pneumococcus and Haemophilus influenzae type b accounted for only 43% of isolates. Thus enteric bacteria may be as important as those bacteria more usually associated with respiratory disease among children presenting with a clinical picture of pneumonia during the wet season. This finding has important implications for case management and surveillance for antibiotic resistance.