Farhana Akram, Mark A C Pietroni, Pradip Kumar Bardhan, Samira Bibi, Mohammod Jobayer Chisti
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引用次数: 9
摘要
我们试图评估五岁以下腹泻儿童(无论男女)患假单胞菌菌血症的患病率、相关因素和结局。利用在线医院管理系统,对2011年1月至2011年12月在孟加拉国国际腹泻病研究中心达卡医院(icddr,b)住院的5岁以下腹泻儿童进行了回顾性图表审查。31例为假单胞菌菌血症患儿,124例为无假单胞菌菌血症的对照组。假单胞菌菌血症患病率为1%(31/ 5179)。假单胞菌多重耐药,但对头孢他啶和亚胺培南的敏感性分别为84%和100%。病例的病死率明显高于对照组(26%对5%;P = 0.003)。在logistic回归分析中,在调整了潜在的混杂因素,如严重消瘦、严重体重不足、严重肺炎和年龄小(11.71(4.0,18.0)个月)后,入院时患者更多表现为无外周脉搏,无脱水(95% CI = 2.31-24.45)。这一发现强调了早期识别这一简单临床症状的重要性,以确保及时进行管理,包括液体复苏和广谱抗生素,以帮助降低这类儿童的发病率和死亡率,特别是在资源贫乏的环境中。
Prevalence, clinical features, and outcome of pseudomonas bacteremia in under-five diarrheal children in bangladesh.
We sought to evaluate the prevalence, associated factors, and outcome of under-five diarrheal children with either sex having Pseudomonas bacteremia. A retrospective chart review of under-five diarrheal children admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), from January 2011 to December 2011 was performed using an online hospital management system. Children with Pseudomonas bacteremia constituted the cases (n = 31), and the controls (n = 124), without Pseudomonas bacteremia, were randomly selected. The prevalence of Pseudomonas bacteremia was 1% (31/5,179). The Pseudomonas was multidrug resistant but was 84% sensitive to ceftazidime and 100% to imipenem. The case-fatality rate was significantly higher among the cases than the controls (26% versus 5%; P = 0.003). In logistic regression analysis, after adjusting for potential confounders such as severe wasting, severe underweight, severe pneumonia, and young age (11.71 (4.0, 18.0) months), the cases more often presented with absent peripheral pulses in absence of dehydration (95% CI = 2.31-24.45) on admission. This finding underscores the importance of early identification of this simple clinical sign to ensure prompt management including fluid resuscitation and broad spectrum antibiotics to help reduce morbidity and mortality in such children, especially in resource-poor settings.