Lepage P, Bogaerts J, Van Goethem C, Ntahorutaba M, Nsengumuremyi F, Hitimana D G, Vandepitte J, Butzler J P, Levy J
Lancet. 1987 Jun 27;1(8548):1458-61. doi: 10.1016/s0140-6736(87)92207-0.
To examine the frequency of community acquired bacteraemia in children in Kigali, Rwanda, blood cultures were obtained from 900 consecutive febrile children (T degrees greater than or equal to 39 degrees C) seen at an outpatient clinic over the course of a year. A pathogen was isolated from 112 children (12.4%): Salmonella typhi from 47, S enteritidis from 23, S typhimurium from 13, Streptococcus pneumoniae from 14, Staphylococcus aureus from 9, and Haemophilus influenzae from 3. Salmonella species represented 74% of the isolates. The children with S typhi bacteraemia were older (mean age 75 months) than those with bacteraemia due to other organisms. Controls consisted of febrile, nonbacteraemic children without (group I) or with (group II) Plasmodium falciparum parasitaemia. Bacteraemic children were older and presented more frequently with diarrhoea, vomiting, and dehydration, but less frequently with convulsions than controls. The rate of hospital admission was higher among bacteraemic children (61%) than among group I (39%) or group II (46%) controls. The case-fatality rate was similar in the three groups (9.3% versus 2.9% and 7.3%). Community-acquired bacteraemia in Rwandese children is common and is mainly caused by Salmonella species.
为了调查卢旺达基加利儿童社区获得性菌血症的发生率，在一年时间里，从一家门诊连续就诊的900名发热儿童（体温T≥39℃）中采集血培养样本。从112名儿童（12.4%）中分离出病原体：47例为伤寒沙门氏菌，23例为肠炎沙门氏菌，13例为鼠伤寒沙门氏菌，14例为肺炎链球菌，9例为金黄色葡萄球菌，3例为流感嗜血杆菌。沙门氏菌属占分离菌株的74%。伤寒沙门氏菌菌血症患儿比其他病原体所致菌血症患儿年龄大（平均年龄75个月）。对照组包括发热但无菌血症的儿童（I组）以及有（II组）恶性疟原虫血症的发热儿童。菌血症患儿年龄较大，腹泻、呕吐和脱水的发生率更高，但惊厥发生率低于对照组。菌血症患儿的住院率（61%）高于I组（39%）或II组（46%）对照组。三组的病死率相似（9.3% 对比2.9%和7.3%）。卢旺达儿童社区获得性菌血症很常见，主要由沙门氏菌属引起。
