Bacterial disease and antimicrobial susceptibility patterns in HIV-Infected, hospitalized children: A retrospective cohort study

dc.contributor.authorJaspan, Heather B.
dc.contributor.authorHuang, Lyen C.
dc.contributor.authorCotton, Mark F.
dc.contributor.authorWhitelaw, Andrew
dc.contributor.authorMyer, Landon
dc.date.accessioned2013-03-19T07:31:15Z
dc.date.available2013-03-19T07:31:15Z
dc.date.issued2008-09-24
dc.descriptionThe orginal version is available at www.plosone.orgen_ZA
dc.description.abstractBackground: Serious bacterial infections are a major source of morbidity and mortality in HIV-infected children. The spectrum of disease is wide, and responsible organisms vary according to setting. The use of antibiotic prophylaxis and the emergence of multi-drug resistant bacteria necessitate examination of responsible organisms and their antibiotic susceptibility. Methodology/Principal Findings: A retrospective cohort study of all HIV-positive pediatric admissions at an urban public sector hospital in Cape Town between January 2002 and June 2006 was conducted. Children between the ages of one month and nine years with laboratory confirmed HIV status, serious bacterial infection, and a hospital length of stay of 5 days or more, were eligible for inclusion. Organisms isolated from blood, urine, and cerebral spinal fluid cultures and their antimicrobial susceptibility were examined, and compared according to timing of isolation to distinguish nosocomial versus community-acquired. One hundred and forty-one children were identified (median age 1.2 years), 39% of whom were on antiretrovirals started before or during this hospitalization. Bacterial infections involved all organ systems, however pneumonia was most common (67%). S. pneumoniae and S. aureus were the most common gram positive and K. pneumoniae was the most common gram negative organism. K pneumoniae isolates were resistant to many first and second line antibiotics, and were all considered nosocomial. All S. aureus isolates were methicillin resistant, some of which were community-acquired. Conclusions/Significance: Bacterial infections are an important source of co-morbidity in HIV-infected children in resourcelimited settings. Clinicians should have a low threshold to initiate antibiotics in children requiring hospitalization. Broadspectrum antibiotics should be used judiciously. Clinicians caring for HIV-infected children should be cognizant of the most common organisms affecting such children, and of their local antimicrobial susceptibilities, when treating empirically for serious bacterial infections.en_ZA
dc.description.versionPublisher's versionen_ZA
dc.format.extent6 p.
dc.identifier.citationJaspan HB, Huang LC, Cotton MF, Whitelaw A, Myer L (2008) Bacterial Disease and Antimicrobial Susceptibility Patterns in HIV-Infected, Hospitalized Children: A Retrospective Cohort Study. PLoS ONE 3(9): e3260.en_ZA
dc.identifier.other10.1371/journal.pone.0003260
dc.identifier.urihttp://hdl.handle.net/10019.1/80449
dc.language.isoen_ZAen_ZA
dc.publisherPLOSen_ZA
dc.rights.holderThe author holds the copyrighten_ZA
dc.subjectHIV-infected children -- Treatmenten_ZA
dc.subjectAntibiotic prophylaxisen_ZA
dc.subjectMulti-drug resistant bacteria in HIV-infected childrenen_ZA
dc.subjectBacterial infections -- Disgnosisen_ZA
dc.subjectHIV-infected children -- Diseases -- Diagnosisen_ZA
dc.subjectPneumonia in children -- Diagnosisen_ZA
dc.subjectHIV-infected children -- Diseases -- Treatmenten_ZA
dc.titleBacterial disease and antimicrobial susceptibility patterns in HIV-Infected, hospitalized children: A retrospective cohort studyen_ZA
dc.typeArticleen_ZA
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