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June 1984

Bacteremia in Hospitalized Black South African Children: A One-Year Study Emphasizing Nosocomial Bacteremia and Bacteremia in Severely Malnourished Children

Author Affiliations

From the Department of Pediatrics, University of the Witwatersrand and Baragwanath Hospital, Johannesburg, Republic of South Africa. Dr Berkowitz is now with the University of Colorado School of Medicine, Denver.

Am J Dis Child. 1984;138(6):551-556. doi:10.1001/archpedi.1984.02140440035008

• During a one-year period, 315 of 5,397 children admitted to the general pediatric wards of a hospital had bacteremia. The commonest causative organisms were Streptococcus pneumoniae, Salmonella enteritidis, Hemophilus influenzae, and Escherichia coli. Most episodes of bacteremia were associated with gastroenteritis, pneumonia, or meningitis. Seventy-eight episodes occurred in children with severe proteinenergy malnutrition, and 46 episodes were hospital acquired. The overall case fatality rate was 23.2%, being highest in children with severe malnutrition and in those with other underlying conditions. The high proportion of bacteremias due to S pneumoniae and S enteritidis possibly reflects infections occurring in a lower socioeconomic group living in a temperate climate in crowded conditions. The most appropriate antimicrobial therapy for children who have suspected bacteremia in association with gastroenteritis or severe malnutrition is a combination of ampicillin sodium and gentamicin sulfate.

(AJDC 1984;138:551-556)

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