TY - JOUR
T1 - Causes of community-acquired bacteremia and patterns of antimicrobial resistance in Vientiane, Laos
AU - Phetsouvanh, Rattanaphone
AU - Phongmany, Simmaly
AU - Soukaloun, Douangdao
AU - Rasachak, Bouachanh
AU - Soukhaseum, Vimone
AU - Soukhaseum, Seun
AU - Frichithavong, Kamthavi
AU - Khounnorath, Sengmanivong
AU - Pengdee, Bounthom
AU - Phiasakha, Khamphong
AU - Chu, Vang
AU - Luangxay, Khonesavanh
AU - Rattanavong, Sayadeth
AU - Sisouk, Konkam
AU - Keolouangkot, Valy
AU - Mayxay, Mayfong
AU - Ramsay, Andrew
AU - Blacksell, Stuart D
AU - Campbell, Jim
AU - Martinez-Aussel, Bertrand
AU - Heuanvongsy, Mayboun
AU - Bounxouei, Bounthapaany
AU - Thammavong, Chanpheng
AU - Syhavong, Bounkong
AU - Strobel, Michel
AU - Peacock, Sharon J
AU - White, Nicholas J
AU - Newton, Paul N
PY - 2006/11
Y1 - 2006/11
N2 - There is no published information on the causes of bacteremia in the Lao PDR (Laos). Between 2000 and 2004, 4512 blood culture pairs were taken from patients admitted to Mahosot Hospital, Vientiane, Laos, with suspected community-acquired bacteremia; 483 (10.7%) cultures grew a clinically significant community-acquired organism, most commonly Salmonella enterica serovar typhi (50.9%), Staphylococcus aureus (19.0%), and Escherichia coli (12.4%). S. aureus bacteremia was common among infants (69.2%), while children 1-5 years had a high frequency of typhoid (44%). Multi-drug-resistant S. Typhi was rare (6%). On multiple logistic regression analysis, typhoid was associated with younger age, longer illness, diarrhea, higher admission temperature, and lower peripheral white blood cell count than non-typhoidal bacteremia. Empirical parenteral ampicillin and gentamicin would have some activity against approximately 88% of clinically significant isolates at a cost of US $1.4/day, an important exception being B. pseudomallei. Bacteremic infants in this setting require an anti-staphylococcal antibiotic.
AB - There is no published information on the causes of bacteremia in the Lao PDR (Laos). Between 2000 and 2004, 4512 blood culture pairs were taken from patients admitted to Mahosot Hospital, Vientiane, Laos, with suspected community-acquired bacteremia; 483 (10.7%) cultures grew a clinically significant community-acquired organism, most commonly Salmonella enterica serovar typhi (50.9%), Staphylococcus aureus (19.0%), and Escherichia coli (12.4%). S. aureus bacteremia was common among infants (69.2%), while children 1-5 years had a high frequency of typhoid (44%). Multi-drug-resistant S. Typhi was rare (6%). On multiple logistic regression analysis, typhoid was associated with younger age, longer illness, diarrhea, higher admission temperature, and lower peripheral white blood cell count than non-typhoidal bacteremia. Empirical parenteral ampicillin and gentamicin would have some activity against approximately 88% of clinically significant isolates at a cost of US $1.4/day, an important exception being B. pseudomallei. Bacteremic infants in this setting require an anti-staphylococcal antibiotic.
KW - Anti-Bacterial Agents/pharmacology
KW - Bacteremia/diagnosis
KW - Blood/microbiology
KW - Child, Preschool
KW - Community-Acquired Infections/diagnosis
KW - Drug Resistance, Bacterial
KW - Gram-Negative Bacteria/drug effects
KW - Gram-Positive Bacteria/drug effects
KW - Humans
KW - Laos/epidemiology
M3 - Article
C2 - 17124000
SN - 0002-9637
VL - 75
SP - 978
EP - 985
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 5
ER -