ArticleBMC infectious diseases2006
Bacteraemia among severely malnourished children infected and uninfected with the human immunodeficiency virus-1 in Kampala, Uganda.
Article in BMC infectious diseases, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 7 of them syntheses that pooled it.
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Who cites it
74 citing papers in PubMed, 7 syntheses or guidelines pooled it, 136 citations in OpenAlex.
- Invasive non-typhoidal Salmonella infections in sub-Saharan Africa: a systematic review on antimicrobial resistance and treatment.BMC medicine · 2020Pooled it
- Guidelines for the treatment of severe acute malnutrition: a systematic review of the evidence for antimicrobial therapy.Paediatrics and international child health · 2018Pooled it
- Pooled it
- A Systematic Review of the Incidence, Risk Factors and Case Fatality Rates of Invasive Nontyphoidal Salmonella (iNTS) Disease in Africa (1966 to 2014).PLoS neglected tropical diseases · 2017Pooled it
- Do children with uncomplicated severe acute malnutrition need antibiotics? A systematic review and meta-analysis.PloS one · 2013Pooled it
- Antibiotics in severely malnourished children: systematic review of efficacy, safety and pharmacokinetics.Bulletin of the World Health Organization · 2011Pooled it
- Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis.The Lancet. Infectious diseases · 2010Pooled it
- Antibiotics as part of the management of severe acute malnutrition.Malawi medical journal : the journal of Medical Association of Malawi · 2016Trial
- Antibiotics as part of the management of severe acute malnutrition.The New England journal of medicine · 2013Trial
- Plasmodium falciparum subverts neutrophil function via host miR-451a loaded extracellular vesicles driving bacterial and fungal superinfection susceptibility.PLoS pathogens · 2026Article
- Acquisition of Escherichia coli carrying extended-spectrum ß-lactamase and carbapenemase genes by hospitalised children with severe acute malnutrition in Niger.Nature communications · 2025Article
- Infections and Antibiotic Resistance in Malawian Children Under Five-Years Old Hospitalized With Severe Acute Malnutrition.Journal of the Pediatric Infectious Diseases Society · 2025Article
- Magnitude and antimicrobial susceptibility profile of bacteria isolated from pediatric sepsis cases at University of Gondar Hospital, Northwest Ethiopia.BMC pediatrics · 2024Article
- Antimicrobial resistance in Enterobacterales infections among children in sub-Saharan Africa: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Vitamin A deficiency impairs neutrophil-mediated control of Salmonella via SLC11A1 in mice.Nature microbiology · 2024Article
- Recovery rate and predictors among children aged 6-59 months with severe acute malnutrition in Addis Ababa, Ethiopia: a retrospective follow-up study.Frontiers in pediatrics · 2024Article
- Article
- Prescribing practices in the treatment of wasting: secondary analysis from a randomised trial.BMJ nutrition, prevention & health · 2024Article
- Evaluating blood culture collection practice in children hospitalized with acute illness at a tertiary hospital in Malawi.Journal of tropical pediatrics · 2023Article
- Impact of childhood malnutrition and intestinal microbiota on MDR infections.JAC-antimicrobial resistance · 2023Review
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo establish the magnitude of bacteraemia in severely malnourished children, and describe the types of bacteria and antimicrobial sensitivity by HIV status.
methodIsolates were recovered from 76 blood specimens. Antibiotic susceptibility tests were performed using commercial antibiotic disks and demographic and clinical findings were recorded.
resultsOf the 450 children 63% were male; median age 17.0 months (inter quartile range, IQR 12-24) and 57% had oedema. 151 (36.7 %) of 411 tested HIV-positive; 76 (17.1%) of 445 blood specimens grew bacterial isolates; 58% were Gram negative - S. typhimurium (27.6%) and S. enteriditis (11.8%). Staph. aureus (26.3%) and Strep. pneumoniae (13.2%) were the main Gram positive organisms. There was no difference in the risk of bacteraemia by HIV status, age < 24 months, male sex, or oedema, except for oral thrush (OR 2.3 CI 1.0-5.1) and hypoalbuminaemia (OR 3.5 CI 1.0-12.1). Isolates from severely immuno-suppressed children (CD4% <15%) were more likely to grow Salmonella enteriditis (OR 5.4; CI 1.6 - 17.4). The isolates were susceptible (> or = 80%) to ciprofloxacin, ceftriaxone and gentamicin; with low susceptibility to chlorampenicol, ampicillin (< 50%) and co-trimoxazole (<25%). Suspicion of bacteraemia had 95.9% sensitivity and 99.2% specificity. Among bacteraemic children, mortality was higher (43.5% vs 20.5%) in the HIV-positive; OR 3.0 (95%CI 1.0, 8.6).
conclusionBacteraemia affects 1 in every 6 severely malnourished children and carries high mortality especially among the HIV-positive. Given the high level of resistance to common antibiotics, there is need for clinical trials to determine the best combinations of antibiotics for management of bacteraemia in severely malnourished children.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.