In:
PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 16, No. 5 ( 2022-5-25), p. e0010414-
Abstract:
Community-acquired bacterial bloodstream infections are caused by diverse pathogens with changing antimicrobial-resistance patterns. In low-middle income countries in Southeast Asia, where dengue fever is endemic and a leading cause of fever, limited information is available about bacterial bloodstream infections due to challenges of implementing a blood culture service. This study describes bacterial bloodstream pathogens and antimicrobial-resistance patterns in Metro Manila, the Philippines. We aimed to identify the proportion of patients with a positive blood culture, the bacteria isolated and their antimicrobial resistance patterns, and the clinical characteristics of these patients, in this dengue endemic area. We conducted a prospective observational study in a single hospital enrolling febrile patients clinically suspected of having a community-acquired bacterial bloodstream infection between 1 st July 2015 and 30 th June 2019. Each patient had a blood culture and additional diagnostic tests according to their clinical presentation. We enrolled 1315 patients and a significant positive blood culture was found in 77 (5.9%) including Staphylococcus aureus (n = 20), Salmonella enterica Typhi (n = 18), Escherichia coli (n = 16), Streptococcus pneumoniae (n = 3) and Burkholderia pseudomallei (n = 2). Thirty-four patients had meningococcal disease diagnosed by culture (n = 8) or blood PCR (n = 26). Additional confirmed diagnoses included leptospirosis (n = 177), dengue virus infection (n = 159) and respiratory diphtheria (n = 50). There were 79 (6.0%, 95%CI 4.8%−7.4%) patients who died within 28 days of enrollment. Patients with a positive blood culture were significantly more likely to die than patients with negative culture (15.2% vs 4.4%, P 〈 0.01). Among S . aureus isolates, 11/20 (55%) were methicillin-resistant (MRSA) and ST30: USA1100 was dominant sequence type (88.9%). Antimicrobial-susceptibility was well preserved in S . enterica Typhi. Among hospitalized patients with clinically suspected community-acquired bacterial bloodstream infection in Metro Manila, the Philippines, 5.9% had a blood culture confirmed infection of whom 15.6% died. S . aureus , including a significant number of MRSA (USA1100 clones), S . enterica Typhi, E . coli and Neisseria meningitidis were frequently identified pathogens.
Type of Medium:
Online Resource
ISSN:
1935-2735
DOI:
10.1371/journal.pntd.0010414
DOI:
10.1371/journal.pntd.0010414.g001
DOI:
10.1371/journal.pntd.0010414.t001
DOI:
10.1371/journal.pntd.0010414.t002
DOI:
10.1371/journal.pntd.0010414.t003
DOI:
10.1371/journal.pntd.0010414.t004
DOI:
10.1371/journal.pntd.0010414.t005
DOI:
10.1371/journal.pntd.0010414.s001
DOI:
10.1371/journal.pntd.0010414.s002
DOI:
10.1371/journal.pntd.0010414.s003
DOI:
10.1371/journal.pntd.0010414.s004
DOI:
10.1371/journal.pntd.0010414.r001
DOI:
10.1371/journal.pntd.0010414.r002
DOI:
10.1371/journal.pntd.0010414.r003
DOI:
10.1371/journal.pntd.0010414.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2429704-5
Bookmarklink