Cited by 851Pneumonia and Respiratory InfectionsNeonatal and Maternal InfectionsSepsis Diagnosis and Treatment

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Bacteremia among Children Admitted to a Rural Hospital in Kenya

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Berkley, James A., Lowe, Brett S., Mwangi, Isaiah, Williams, Thomas, Bauni, Evasius, Mwarumba, Saleem, Ngetsa, Caroline, Slack, Mary P.E., Njenga, Sally, Hart, C. Anthony, Maitland, Kathryn, English, Mike, Marsh, Kevin, Scott, J. Anthony G.·2005·New England Journal of Medicine

DOI 10.1056/nejmoa040275

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Abstract

BACKGROUND: There are few epidemiologic data on invasive bacterial infections among children in sub-Saharan Africa. We studied every acute pediatric admission to a rural district hospital in Kenya to examine the prevalence, incidence, types, and outcome of community-acquired bacteremia. METHODS: Between August 1998 and July 2002, we cultured blood on admission from 19,339 inpatients and calculated the incidence of bacteremia on the basis of the population served by the hospital. RESULTS: Of a total of 1783 infants who were under 60 days old, 228 had bacteremia (12.8 percent), as did 866 of 14,787 children who were 60 or more days of age (5.9 percent). Among infants who were under 60 days old, Escherichia coli and group B streptococci predominated among a broad range of isolates (14 percent and 11 percent, respectively). Among infants who were 60 or more days of age, Streptococcus pneumoniae, nontyphoidal salmonella species, Haemophilus influenzae, and E. coli accounted for more than 70 percent of isolates. The minimal annual incidence of community-acquired bacteremia was estimated at 1457 cases per 100,000 children among infants under a year old, 1080 among children under 2 years, and 505 among children under 5 years. Of all in-hospital deaths, 26 percent were in children with community-acquired bacteremia. Of 308 deaths in children with bacteremia, 103 (33.4 percent) occurred on the day of admission and 217 (70.5 percent) within two days. CONCLUSIONS: Community-acquired bacteremia is a major cause of death among children at a rural sub-Saharan district hospital, a finding that highlights the need for prevention and for overcoming the political and financial barriers to widespread use of existing vaccines for bacterial diseases.

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Authors: Berkley, J. A., Lowe, B. S., Mwangi, I., Williams, T., Bauni, E., Mwarumba, S., Ngetsa, C., Slack, M. P. E., Njenga, S., Hart, C. A., Maitland, K., English, M., Marsh, K., & Scott, J. A. G.
Affiliations: University of Oxford (GB)
John Radcliffe Hospital (GB)
University of Liverpool (GB)
ORCID: Berkley, James A.
Lowe, Brett S.
Mwangi, Isaiah
Williams, Thomas
Ngetsa, Caroline
Slack, Mary P.E.
Hart, C. Anthony
Maitland, Kathryn
English, Mike
Marsh, Kevin
Scott, J. Anthony G.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2005-01-06
Volume: 352
Issue: 1
Pages: 39-47
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa040275
OpenAlex: W2115179234
Cited by: 851
References: 23
Citations by year: 2026: 15 · 2025: 13 · 2024: 19 · 2023: 23 · 2022: 20 · 2021: 21 · 2020: 41 · 2019: 43 · 2018: 33 · 2017: 37 · 2016: 42 · 2015: 62 · 2014: 58 · 2013: 44 · 2012: 61
FWCI: 34.05
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
Funders: Wellcome Trust (061089, 081835)
Topics: Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Keywords: community-acquired bacteremia, pediatric bacteremia, invasive bacterial infection, infants, Escherichia coli, Streptococcus agalactiae, Streptococcus pneumoniae, non-typhoidal Salmonella, Haemophilus influenzae, in-hospital mortality, sub-Saharan Africa, rural Kenya, bacterial vaccines
MeSH terms: Bacteria, Cause of Death, Child, Child, Preschool, Female, Haemophilus Infections, Hospitals, Rural, Humans, Infant, Kenya, Male, Pneumococcal Infections, Prospective Studies, HIV Infections, Incidence, Logistic Models, Bacteremia, Hospital Mortality, Community-Acquired Infections, Haemophilus influenzae type b, Malnutrition

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Bacteremia among Children Admitted to a Rural Hospital in Kenya

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