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The Lancet Infect Dis. Community-acquired bacterial bloodstream infections in developing countries in south and southeast Asia: a systematic review

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  • The Lancet Infect Dis. Community-acquired bacterial bloodstream infections in developing countries in south and southeast Asia: a systematic review

    [Source: The Lancet Infectious Diseases, full text: (LINK). Abstract, edited.]
    The Lancet Infectious Diseases, Volume 12, Issue 6, Pages 480 - 487, June 2012

    doi:10.1016/S1473-3099(12)70028-2

    Community-acquired bacterial bloodstream infections in developing countries in south and southeast Asia: a systematic review



    Original Text

    Dr Jacqueline Deen MD, Lorenz von Seidlein PhD, Finn Andersen, Nelson Elle MD, Prof Nicholas J White MD, Yoel Lubell PhD



    Summary
    Information about community-acquired bacteraemia in developing countries in south and southeast Asia is scarce. We aimed to establish the case fraction of bacteraemia in febrile patients admitted to hospital. We searched four databases and identified studies of south and southeast Asia published between 1990 and 2010 that prospectively assessed patients admitted to hospital and from whom a blood culture was taken. We reviewed 17 eligible studies describing 40 644 patients. Pathogenic organisms were isolated from 3506 patients (9%; range 151%); 1784 (12%) of 14 386 adults and 1722 (7%) of 26 258 children. Salmonella enterica serotype Typhi was the most common bacterial pathogen, accounting for 532 of 1798 (30%) isolates in adults and 432 of 1723 (25%) in children. Other commonly isolated organisms in adults were Staphylococcus aureus, Escherichia coli, and other Gram-negative organisms, and in children were Streptococcus pneumoniae and Haemophilus influenzae. A substantial case fraction of bacteraemia occurs in patients admitted to hospital with fever in this region. Management could be improved if diagnostic microbiology facilities were more widely available. The prevailing organisms causing bacteraemia and their susceptibility patterns could inform empirical treatment regimens and prevention strategies.

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