Community Acquired Bacteremia in Young Children from Central Nigeria- A Pilot Study

Stephen Obaro, Lovett Lawson, Uduak Essen, Khalid Ibrahim, Kevin Brooks, Adekunle Otuneye, Denis Shetima, Patience Ahmed, Theresa Ajose, Michael Olugbile, David Idiong, Damola Ogundeji, Comfort Ochigbo, Grace Olanipekun, Walid Khalife, Richard Adegbola

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Reports of the etiology of bacteremia in children from Nigeria are sparse and have been confounded by wide spread non-prescription antibiotic use and suboptimal laboratory culture techniques. We aimed to determine causative agents and underlying predisposing conditions of bacteremia in Nigerian children using data arising during the introduction of an automated blood culture system accessed by 7 hospitals and clinics in the Abuja area.Methods: Between September 2008 and November 2009, we enrolled children with clinically suspected bacteremia at rural and urban clinical facilities in Abuja or within the Federal Capital Territory of Nigeria. Blood was cultured using an automated system with antibiotic removing device. We documented clinical features in all children and tested for prior antibiotic use in a random sample of sera from children from each site.Results: 969 children aged 2 months-5 years were evaluated. Mean age was 21 ± 15.2 months. All children were not systematically screened but there were 59 (6%) children with established diagnosis of sickle cell disease and 42 (4.3%) with HIV infection. Overall, 212 (20.7%) had a positive blood culture but in only 105 (10.8%) were these considered to be clinically significant. Three agents, Staphylococcus aureus (20.9%), Salmonella typhi (20.9%) and Acinetobacter (12.3%) accounted for over half of the positive cultures. Streptococcus pneumoniae and non-typhi Salmonellae each accounted for 7.6%. Although not the leading cause of bacteremia, Streptococcus pneumoniae was the single leading cause of all deaths that occurred during hospitalization and after hospital discharge.Conclusion: S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting. This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children. Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.

Original languageEnglish (US)
Article number137
JournalBMC Infectious Diseases
Volume11
DOIs
StatePublished - May 19 2011

Fingerprint

Nigeria
Bacteremia
Streptococcus pneumoniae
Salmonella typhi
Anti-Bacterial Agents
Salmonella
Culture Techniques
Acinetobacter
Sickle Cell Anemia
HIV Infections
Staphylococcus aureus
Cause of Death
Hospitalization
Vaccines
Public Health
Economics
Morbidity
Equipment and Supplies
Mortality
Serum

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Community Acquired Bacteremia in Young Children from Central Nigeria- A Pilot Study. / Obaro, Stephen; Lawson, Lovett; Essen, Uduak; Ibrahim, Khalid; Brooks, Kevin; Otuneye, Adekunle; Shetima, Denis; Ahmed, Patience; Ajose, Theresa; Olugbile, Michael; Idiong, David; Ogundeji, Damola; Ochigbo, Comfort; Olanipekun, Grace; Khalife, Walid; Adegbola, Richard.

In: BMC Infectious Diseases, Vol. 11, 137, 19.05.2011.

Research output: Contribution to journalArticle

Obaro, S, Lawson, L, Essen, U, Ibrahim, K, Brooks, K, Otuneye, A, Shetima, D, Ahmed, P, Ajose, T, Olugbile, M, Idiong, D, Ogundeji, D, Ochigbo, C, Olanipekun, G, Khalife, W & Adegbola, R 2011, 'Community Acquired Bacteremia in Young Children from Central Nigeria- A Pilot Study', BMC Infectious Diseases, vol. 11, 137. https://doi.org/10.1186/1471-2334-11-137
Obaro, Stephen ; Lawson, Lovett ; Essen, Uduak ; Ibrahim, Khalid ; Brooks, Kevin ; Otuneye, Adekunle ; Shetima, Denis ; Ahmed, Patience ; Ajose, Theresa ; Olugbile, Michael ; Idiong, David ; Ogundeji, Damola ; Ochigbo, Comfort ; Olanipekun, Grace ; Khalife, Walid ; Adegbola, Richard. / Community Acquired Bacteremia in Young Children from Central Nigeria- A Pilot Study. In: BMC Infectious Diseases. 2011 ; Vol. 11.
@article{34b0b40066354f16947a03a04db392e1,
title = "Community Acquired Bacteremia in Young Children from Central Nigeria- A Pilot Study",
abstract = "Background: Reports of the etiology of bacteremia in children from Nigeria are sparse and have been confounded by wide spread non-prescription antibiotic use and suboptimal laboratory culture techniques. We aimed to determine causative agents and underlying predisposing conditions of bacteremia in Nigerian children using data arising during the introduction of an automated blood culture system accessed by 7 hospitals and clinics in the Abuja area.Methods: Between September 2008 and November 2009, we enrolled children with clinically suspected bacteremia at rural and urban clinical facilities in Abuja or within the Federal Capital Territory of Nigeria. Blood was cultured using an automated system with antibiotic removing device. We documented clinical features in all children and tested for prior antibiotic use in a random sample of sera from children from each site.Results: 969 children aged 2 months-5 years were evaluated. Mean age was 21 ± 15.2 months. All children were not systematically screened but there were 59 (6{\%}) children with established diagnosis of sickle cell disease and 42 (4.3{\%}) with HIV infection. Overall, 212 (20.7{\%}) had a positive blood culture but in only 105 (10.8{\%}) were these considered to be clinically significant. Three agents, Staphylococcus aureus (20.9{\%}), Salmonella typhi (20.9{\%}) and Acinetobacter (12.3{\%}) accounted for over half of the positive cultures. Streptococcus pneumoniae and non-typhi Salmonellae each accounted for 7.6{\%}. Although not the leading cause of bacteremia, Streptococcus pneumoniae was the single leading cause of all deaths that occurred during hospitalization and after hospital discharge.Conclusion: S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting. This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children. Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.",
author = "Stephen Obaro and Lovett Lawson and Uduak Essen and Khalid Ibrahim and Kevin Brooks and Adekunle Otuneye and Denis Shetima and Patience Ahmed and Theresa Ajose and Michael Olugbile and David Idiong and Damola Ogundeji and Comfort Ochigbo and Grace Olanipekun and Walid Khalife and Richard Adegbola",
year = "2011",
month = "5",
day = "19",
doi = "10.1186/1471-2334-11-137",
language = "English (US)",
volume = "11",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Community Acquired Bacteremia in Young Children from Central Nigeria- A Pilot Study

AU - Obaro, Stephen

AU - Lawson, Lovett

AU - Essen, Uduak

AU - Ibrahim, Khalid

AU - Brooks, Kevin

AU - Otuneye, Adekunle

AU - Shetima, Denis

AU - Ahmed, Patience

AU - Ajose, Theresa

AU - Olugbile, Michael

AU - Idiong, David

AU - Ogundeji, Damola

AU - Ochigbo, Comfort

AU - Olanipekun, Grace

AU - Khalife, Walid

AU - Adegbola, Richard

PY - 2011/5/19

Y1 - 2011/5/19

N2 - Background: Reports of the etiology of bacteremia in children from Nigeria are sparse and have been confounded by wide spread non-prescription antibiotic use and suboptimal laboratory culture techniques. We aimed to determine causative agents and underlying predisposing conditions of bacteremia in Nigerian children using data arising during the introduction of an automated blood culture system accessed by 7 hospitals and clinics in the Abuja area.Methods: Between September 2008 and November 2009, we enrolled children with clinically suspected bacteremia at rural and urban clinical facilities in Abuja or within the Federal Capital Territory of Nigeria. Blood was cultured using an automated system with antibiotic removing device. We documented clinical features in all children and tested for prior antibiotic use in a random sample of sera from children from each site.Results: 969 children aged 2 months-5 years were evaluated. Mean age was 21 ± 15.2 months. All children were not systematically screened but there were 59 (6%) children with established diagnosis of sickle cell disease and 42 (4.3%) with HIV infection. Overall, 212 (20.7%) had a positive blood culture but in only 105 (10.8%) were these considered to be clinically significant. Three agents, Staphylococcus aureus (20.9%), Salmonella typhi (20.9%) and Acinetobacter (12.3%) accounted for over half of the positive cultures. Streptococcus pneumoniae and non-typhi Salmonellae each accounted for 7.6%. Although not the leading cause of bacteremia, Streptococcus pneumoniae was the single leading cause of all deaths that occurred during hospitalization and after hospital discharge.Conclusion: S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting. This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children. Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.

AB - Background: Reports of the etiology of bacteremia in children from Nigeria are sparse and have been confounded by wide spread non-prescription antibiotic use and suboptimal laboratory culture techniques. We aimed to determine causative agents and underlying predisposing conditions of bacteremia in Nigerian children using data arising during the introduction of an automated blood culture system accessed by 7 hospitals and clinics in the Abuja area.Methods: Between September 2008 and November 2009, we enrolled children with clinically suspected bacteremia at rural and urban clinical facilities in Abuja or within the Federal Capital Territory of Nigeria. Blood was cultured using an automated system with antibiotic removing device. We documented clinical features in all children and tested for prior antibiotic use in a random sample of sera from children from each site.Results: 969 children aged 2 months-5 years were evaluated. Mean age was 21 ± 15.2 months. All children were not systematically screened but there were 59 (6%) children with established diagnosis of sickle cell disease and 42 (4.3%) with HIV infection. Overall, 212 (20.7%) had a positive blood culture but in only 105 (10.8%) were these considered to be clinically significant. Three agents, Staphylococcus aureus (20.9%), Salmonella typhi (20.9%) and Acinetobacter (12.3%) accounted for over half of the positive cultures. Streptococcus pneumoniae and non-typhi Salmonellae each accounted for 7.6%. Although not the leading cause of bacteremia, Streptococcus pneumoniae was the single leading cause of all deaths that occurred during hospitalization and after hospital discharge.Conclusion: S. typhi is a significant cause of vaccine-preventable morbidity while S. pneumoniae may be a leading cause of mortality in this setting. This observation contrasts with reports from most other African countries where non-typhi Salmonellae are predominant in young children. Expanded surveillance is required to confirm the preliminary observations from this pilot study to inform implementation of appropriate public health control measures.

UR - http://www.scopus.com/inward/record.url?scp=79955983056&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955983056&partnerID=8YFLogxK

U2 - 10.1186/1471-2334-11-137

DO - 10.1186/1471-2334-11-137

M3 - Article

C2 - 21595963

AN - SCOPUS:79955983056

VL - 11

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

SN - 1471-2334

M1 - 137

ER -