The burden of invasive bacterial infections in Pemba, Zanzibar.
The burden of invasive bacterial infections in Pemba, Zanzibar.
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DOI：
10.1371/journal.pone.0030350
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Deen JL
中科院分区：
文献类型：
--
作者：
Thriemer K;Ley B;Ame S;von Seidlein L;Pak GD;Chang NY;Hashim R;Schmied WH;Busch CJ;Nixon S;Morrissey A;Puri MK;Ali M;Ochiai RL;Wierzba T;Jiddawi MS;Clemens JD;Ali SM;Deen JL
我们进行了一项监测研究，以确定在坦桑尼亚桑给巴尔奔巴岛的三家地区医院寻求治疗的发烧患者血液感染的主要原因，该地区是疟疾传播率较低的地区。所有2个月以上的发热患者都进行了筛查，并采集血液进行微生物培养和疟疾检测。计算了一年内细菌败血症和疟疾的粗发病率，并根据研究参与度和血培养诊断敏感性进行了调整。对2209名患者进行了血培养。其中细菌生长166例(8%)，疑似污染物87例(4%)，致病菌79例(4%)。最常见的病原菌是伤寒沙门氏菌(n = 46，58%)，其次是肺炎链球菌(n = 12，15%)。粗菌血症发生率为6/10万，但根据可能漏诊的病例进行调整后，这一比率可能高达163/10万。伤寒沙门氏菌感染和疟疾的粗率和调整率分别为4和110/10万和4和47/10万。伤寒沙门氏菌对氨苄西林、氯霉素和复方新诺明的耐药率分别为53%、22%和49%。42%的分离株对3种抗菌素产生多药耐药。在疟疾发病率很低的情况下，我们发现桑给巴尔奔巴岛的伤寒沙门氏菌和肺炎沙门氏菌感染率很高。接种疫苗等预防措施可减轻发热性疾病负担。
We conducted a surveillance study to determine the leading causes of bloodstream infection in febrile patients seeking treatment at three district hospitals in Pemba Island, Zanzibar, Tanzania, an area with low malaria transmission. All patients above two months of age presenting to hospital with fever were screened, and blood was collected for microbiologic culture and malaria testing. Bacterial sepsis and malaria crude incidence rates were calculated for a one-year period and were adjusted for study participation and diagnostic sensitivity of blood culture. Blood culture was performed on 2,209 patients. Among them, 166 (8%) samples yielded bacterial growth; 87 (4%) were considered as likely contaminants; and 79 (4%) as pathogenic bacteria. The most frequent pathogenic bacteria isolated were Salmonella Typhi (n = 46; 58%), followed by Streptococcus pneumoniae (n = 12; 15%). The crude bacteremia rate was 6/100,000 but when adjusted for potentially missed cases the rate may be as high as 163/100,000. Crude and adjusted rates for S. Typhi infections and malaria were 4 and 110/100,000 and 4 and 47/100,000, respectively. Twenty three (51%), 22 (49%) and 22 (49%) of the S.Typhi isolates were found to be resistant toward ampicillin, chloramphenicol and cotrimoxazole, respectively. Multidrug resistance (MDR) against the three antimicrobials was detected in 42% of the isolates. In the presence of very low malaria incidence we found high rates of S. Typhi and S. pneumoniae infections on Pemba Island, Zanzibar. Preventive measures such as vaccination could reduce the febrile disease burden.
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