Reed R P, Wegerhoff F O, Rothberg A D
Shongwe Mission Hospital, University of the Witwatersrand, Johannesburg, Republic of South Africa.
Ann Trop Paediatr. 1996 Mar;16(1):61-8. doi: 10.1080/02724936.1996.11747805.
During a 5-month study period, 323 of 863 (37.5%) children below 5 years of age admitted to Shongwe Mission Hospital in rural South Africa were malnourished, two-thirds severely so. The incidence of bacteraemia in malnourished children was 9.6%, 11.8% in those severely malnourished and 5.8% in nutritional dwarfs. The predominant organisms retrieved were Gram-negative enteric bacilli (48.5%). Amongst the severely malnourished, who empirically receive intravenous ampicillin and gentamicin, 95.8% of all isolates were sensitive to this antibiotic combination. The case fatality rate of severely malnourished bacteraemic children was 20.8%. In malnutrition categories overall, the case fatality rate for bacteraemic children (22.6%) was significantly greater than in those without bacteraemia (9.3%). In hospitals with limited resources, full identification of bacteria may not be necessary, provided that regular surveillance for emerging resistance is conducted.
在为期5个月的研究期间，南非农村地区松圭教会医院收治的863名5岁以下儿童中有323名（37.5%）营养不良，其中三分之二为重度营养不良。营养不良儿童的菌血症发病率为9.6%，重度营养不良儿童为11.8%，营养性侏儒为5.8%。检出的主要病原体是革兰氏阴性肠道杆菌（48.5%）。在经验性接受静脉注射氨苄西林和庆大霉素治疗的重度营养不良儿童中，所有分离株中有95.8%对这种抗生素组合敏感。重度营养不良菌血症儿童的病死率为20.8%。总体而言，在各类营养不良中，菌血症儿童的病死率（22.6%）显著高于无菌血症儿童（9.3%）。在资源有限的医院，只要定期监测新出现的耐药情况，可能无需对细菌进行全面鉴定。
