Wolf B H, Ikeogu M O, Vos E T
Department of Paediatrics, Mpilo Central Hospital, Bulawayo, Zimbabwe.
Eur J Pediatr. 1995 Apr;154(4):299-303. doi: 10.1007/BF01957366.
From July 1992 to May 1993 a study was performed of the relationship between bacteraemia, nutritional status and HIV status in 212 out of 334 consecutive infants and children aged 0-5 years, who had died at home in Bulawayo, Zimbabwe. The remaining 122 children were excluded because the time period between death and arrival at the hospital was over 3 h. A pathogen was isolated from 92 (43%) children and Klebsiella species were most commonly isolated. A positive HIV-1 serology was found in 122 (58%) children and 110 (52%) children were malnourished. Malnutrition was significantly associated with bacteraemia at death after adjustment for the confounding effect of age and HIV status (odds ratio 4.28; 95% CI 2.27-8.07; P < 0.001). No association was found between either HIV serostatus or proven HIV infection and bacteraemia, which could not be attributed to nutritional status. Conclusion. Bacteraemia, in particular with Gram-negative bacteria, is an important cause of death in malnourished children in Zimbabwe regardless of their HIV-1 antibody status.
1992年7月至1993年5月，对津巴布韦布拉瓦约334名连续死亡的0至5岁婴幼儿及儿童中的212名进行了菌血症、营养状况与艾滋病毒感染状况之间关系的研究。其余122名儿童被排除，因为其死亡至抵达医院的时间超过3小时。92名（43%）儿童分离出病原体，最常见的是克雷伯菌属。122名（58%）儿童HIV-1血清学检测呈阳性，110名（52%）儿童营养不良。在对年龄和艾滋病毒感染状况的混杂效应进行校正后，营养不良与死亡时的菌血症显著相关（比值比4.28；95%可信区间2.27 - 8.07；P < 0.001）。未发现艾滋病毒血清学状态或确诊的艾滋病毒感染与菌血症之间存在关联，且这种关联不能归因于营养状况。结论。无论艾滋病毒-1抗体状态如何，菌血症，尤其是革兰氏阴性菌引起的菌血症，是津巴布韦营养不良儿童死亡的重要原因。
