Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study
| dc.contributor.author | Buys, Heloise | |
| dc.contributor.author | Muloiwa, Rudzani | |
| dc.contributor.author | Bamford, Colleen | |
| dc.contributor.author | Eley, Brian | |
| dc.date.accessioned | 2016-11-01T10:12:06Z | |
| dc.date.available | 2016-11-01T10:12:06Z | |
| dc.date.issued | 2016-10-17 | |
| dc.date.updated | 2016-10-17T18:06:11Z | |
| dc.description.abstract | Background: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data from Africa. In this study we describe the epidemiology of multi-drug resistant Klebsiella pneumoniae bloodstream infection (KPBSI) at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods: We conducted a retrospective cross-sectional study of KPBSI from 1 January 2006 to 31 December 2011 using conventional descriptive and inferential statistical methods. Results: Of 410 hospitalised children with laboratory confirmed KPBSI, 339 (83 %) were caused by extendedspectrum β-lactamase (ESBL) producing isolates. The median age (IQR) was 5.0 (2–16) months, 212 (51.7 %) were male, 82 (20 %) were HIV-infected, and 241 (58.8 %) were moderately or severely underweight. The infection was hospital-acquired or healthcare-associated in 389 (95 %) children and community-acquired in 21 (5 %) children. Significant risk factors for ESBL-KPBSI included cephalosporin exposure in the 12 months prior to the KPBSI, adjusted risk ratio (aRR) 1.18 (95 % CI: 1.06–1.31); HIV infection, aRR 1.14 (1.04–1.25), and intravenous infusions for more than 3 days before the KPBSI, aRR 1.15 (95 % CI: 1.04–1.28). A total of 109 (26.6 %) children died within 30 days of the KPBSI, their median age was four (IQR 1–11) months. The median (IQR) time between KPBSI and death was three (1–9) days. HIV-infection, aRR 2.44(95 % CI: 1.59–3.74); skin erosions at the time of KPBSI, aRR 2.15 (95 % CI: 1.54–3.00); being in PICU at the time of the KPBSI, aRR 1.64 (95 % CI: 1.03–2.61) or needing PICU admission after developing KPBSI, aRR 1.72 (95 % CI: 1.10–2.70) were significant risk factors for death. Conclusion: ESBL-producing KP is an important cause of laboratory confirmed bloodstream infection in hospitalised children and is associated with high mortality. | en_ZA |
| dc.identifier.apacitation | Buys, H., Muloiwa, R., Bamford, C., & Eley, B. (2016). Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/22386 | en_ZA |
| dc.identifier.chicagocitation | Buys, Heloise, Rudzani Muloiwa, Colleen Bamford, and Brian Eley "Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study." <i>BMC Infectious Diseases</i> (2016) http://hdl.handle.net/11427/22386 | en_ZA |
| dc.identifier.citation | Buys, H., Muloiwa, R., Bamford, C., & Eley, B. (2016). Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study. BMC Infectious Diseases, 16(1), 570. | en_ZA |
| dc.identifier.issn | 1471-2334 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Buys, Heloise AU - Muloiwa, Rudzani AU - Bamford, Colleen AU - Eley, Brian AB - Background: Klebsiella pneumoniae (KP) is a significant paediatric bloodstream pathogen in children. There is little data from Africa. In this study we describe the epidemiology of multi-drug resistant Klebsiella pneumoniae bloodstream infection (KPBSI) at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods: We conducted a retrospective cross-sectional study of KPBSI from 1 January 2006 to 31 December 2011 using conventional descriptive and inferential statistical methods. Results: Of 410 hospitalised children with laboratory confirmed KPBSI, 339 (83 %) were caused by extendedspectrum β-lactamase (ESBL) producing isolates. The median age (IQR) was 5.0 (2–16) months, 212 (51.7 %) were male, 82 (20 %) were HIV-infected, and 241 (58.8 %) were moderately or severely underweight. The infection was hospital-acquired or healthcare-associated in 389 (95 %) children and community-acquired in 21 (5 %) children. Significant risk factors for ESBL-KPBSI included cephalosporin exposure in the 12 months prior to the KPBSI, adjusted risk ratio (aRR) 1.18 (95 % CI: 1.06–1.31); HIV infection, aRR 1.14 (1.04–1.25), and intravenous infusions for more than 3 days before the KPBSI, aRR 1.15 (95 % CI: 1.04–1.28). A total of 109 (26.6 %) children died within 30 days of the KPBSI, their median age was four (IQR 1–11) months. The median (IQR) time between KPBSI and death was three (1–9) days. HIV-infection, aRR 2.44(95 % CI: 1.59–3.74); skin erosions at the time of KPBSI, aRR 2.15 (95 % CI: 1.54–3.00); being in PICU at the time of the KPBSI, aRR 1.64 (95 % CI: 1.03–2.61) or needing PICU admission after developing KPBSI, aRR 1.72 (95 % CI: 1.10–2.70) were significant risk factors for death. Conclusion: ESBL-producing KP is an important cause of laboratory confirmed bloodstream infection in hospitalised children and is associated with high mortality. DA - 2016-10-17 DB - OpenUCT DO - 10.1186/s12879-016-1919-y DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 SM - 1471-2334 T1 - Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study TI - Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study UR - http://hdl.handle.net/11427/22386 ER - | en_ZA |
| dc.identifier.uri | http://dx.doi.org/10.1186/s12879-016-1919-y | |
| dc.identifier.uri | http://hdl.handle.net/11427/22386 | |
| dc.identifier.vancouvercitation | Buys H, Muloiwa R, Bamford C, Eley B. Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study. BMC Infectious Diseases. 2016; http://hdl.handle.net/11427/22386. | en_ZA |
| dc.language | eng | en_ZA |
| dc.language.rfc3066 | en | |
| dc.publisher | BioMed Central | en_ZA |
| dc.publisher.department | Department of Paediatrics and Child Health | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights | Creative Commons Attribution 4.0 International (CC BY 4.0) | * |
| dc.rights.holder | The Author(s). | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_ZA |
| dc.source | BMC Infectious Diseases | en_ZA |
| dc.source | http://bmcinfectdis.biomedcentral.com/ | |
| dc.source.journalissue | 1 | |
| dc.source.journalvolume | 23 | |
| dc.source.pagination | 302 | |
| dc.source.uri | https://bmcpediatr.biomedcentral.com/ | |
| dc.subject.other | Klebsiella pneumoniae bloodstream infection | |
| dc.subject.other | Children | |
| dc.subject.other | Africa | |
| dc.title | Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study | en_ZA |
| dc.type | Journal Article | en_ZA |
| uct.type.filetype | Text | |
| uct.type.filetype | Image | |
| uct.type.publication | Research | en_ZA |
| uct.type.resource | Article | en_ZA |