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

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dc.contributor.authorJaspan, Heather Ben_ZA
dc.contributor.authorHuang, Lyen Cen_ZA
dc.contributor.authorCotton, Mark Fen_ZA
dc.contributor.authorWhitelaw, Andrewen_ZA
dc.contributor.authorMyer, Landonen_ZA
dc.date.accessioned2016-01-11T06:55:14Z
dc.date.available2016-01-11T06:55:14Z
dc.date.issued2008en_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 resource-limited settings. Clinicians should have a low threshold to initiate antibiotics in children requiring hospitalization. Broad-spectrum 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.identifier.apacitationJaspan, H. B., Huang, L. C., Cotton, M. F., Whitelaw, A., & Myer, L. (2008). Bacterial disease and antimicrobial susceptibility patterns in HIV-infected, hospitalized children: a retrospective cohort study. <i>PLoS One</i>, http://hdl.handle.net/11427/16296en_ZA
dc.identifier.chicagocitationJaspan, Heather B, Lyen C Huang, Mark F Cotton, Andrew Whitelaw, and Landon Myer "Bacterial disease and antimicrobial susceptibility patterns in HIV-infected, hospitalized children: a retrospective cohort study." <i>PLoS One</i> (2008) http://hdl.handle.net/11427/16296en_ZA
dc.identifier.citationJaspan, H. B., Huang, L. C., Cotton, M. F., Whitelaw, A., & Myer, L. (2008). Bacterial disease and antimicrobial susceptibility patterns in HIV-infected, hospitalized children: a retrospective cohort study. PLoS One, 3(9). doi:10.1371/journal.pone.0003260en_ZA
dc.identifier.ris TY - Journal Article AU - Jaspan, Heather B AU - Huang, Lyen C AU - Cotton, Mark F AU - Whitelaw, Andrew AU - Myer, Landon AB - BACKGROUND: 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 resource-limited settings. Clinicians should have a low threshold to initiate antibiotics in children requiring hospitalization. Broad-spectrum 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. DA - 2008 DB - OpenUCT DO - 10.1371/journal.pone.0003260 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2008 T1 - Bacterial disease and antimicrobial susceptibility patterns in HIV-infected, hospitalized children: a retrospective cohort study TI - Bacterial disease and antimicrobial susceptibility patterns in HIV-infected, hospitalized children: a retrospective cohort study UR - http://hdl.handle.net/11427/16296 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16296
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0003260
dc.identifier.vancouvercitationJaspan HB, Huang LC, Cotton MF, Whitelaw A, Myer L. Bacterial disease and antimicrobial susceptibility patterns in HIV-infected, hospitalized children: a retrospective cohort study. PLoS One. 2008; http://hdl.handle.net/11427/16296.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentDivision of Medical Biochemistryen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2008 Jaspan et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherBacterial diseasesen_ZA
dc.subject.otherChildrenen_ZA
dc.subject.otherNosocomial infectionsen_ZA
dc.subject.otherKlebsiella pneumoniaeen_ZA
dc.subject.otherPneumoniaen_ZA
dc.subject.otherBlooden_ZA
dc.subject.otherAntibiotic resistanceen_ZA
dc.subject.otherAntibioticsen_ZA
dc.titleBacterial disease and antimicrobial susceptibility patterns in HIV-infected, hospitalized children: a retrospective cohort studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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