The burden of Invasive Bacterial Infections in Pemba, Zanibar

Kamala Thriemer, Benedikt Ley, Shaali Ame, Lorenz von Seidlein, Giok de Pak, Na Yoon Chang, Ramadhan Hashim, Wolfgang Hellmut Schmied, Clara Jana Lui BuschClara, Shanette Nixon, Anne Morrissey, Mahesh K. Puri, Mohammad Ali, R. Leon Ochiai, Thomas Wierzba, Mohammad S. Jiddawi, John D. Clemens, Said M. Ali, Jaqueline L. Deen

    Research output: Contribution to journalArticleResearchpeer-review

    6 Downloads (Pure)

    Abstract

    Background: We conducted a surveillance study to determine the leading causes of bloodstream infection in febrile patients seeking treatment at three district hospitals in Pemba Island, Zanzibar, Tanzania, an area with low malaria transmission.

    Methods: All patients above two months of age presenting to hospital with fever were screened, and blood was collected for microbiologic culture and malaria testing. Bacterial sepsis and malaria crude incidence rates were calculated for a one-year period and were adjusted for study participation and diagnostic sensitivity of blood culture.

    Results: Blood culture was performed on 2,209 patients. Among them, 166 (8%) samples yielded bacterial growth; 87 (4%) were considered as likely contaminants; and 79 (4%) as pathogenic bacteria. The most frequent pathogenic bacteria isolated were Salmonella Typhi (n = 46; 58%), followed by Streptococcus pneumoniae (n = 12; 15%). The crude bacteremia rate was 6/100,000 but when adjusted for potentially missed cases the rate may be as high as 163/100,000. Crude and adjusted rates for S. Typhi infections and malaria were 4 and 110/100,000 and 4 and 47/100,000, respectively. Twenty three (51%), 22 (49%) and 22 (49%) of the S.Typhi isolates were found to be resistant toward ampicillin, chloramphenicol and cotrimoxazole, respectively. Multidrug resistance (MDR) against the three antimicrobials was detected in 42% of the isolates.

    Conclusions: In the presence of very low malaria incidence we found high rates of S. Typhi and S. pneumoniae infections on Pemba Island, Zanzibar. Preventive measures such as vaccination could reduce the febrile disease burden.

    Original languageEnglish
    Article numbere30350
    Pages (from-to)1-9
    Number of pages9
    JournalPLoS One
    Volume7
    Issue number2
    DOIs
    Publication statusPublished - 17 Feb 2012

    Fingerprint

    Indian Ocean Islands
    bacterial infections
    Bacterial Infections
    malaria
    Malaria
    Blood
    Salmonella Typhi
    Salmonella typhi
    Tanzania
    Bacteria
    Zanzibar
    fever
    Streptococcus pneumoniae
    Fever
    Patient treatment
    Salmonella
    Islands
    Sulfamethoxazole Drug Combination Trimethoprim
    Chloramphenicol
    Ampicillin

    Cite this

    Thriemer, K., Ley, B., Ame, S., von Seidlein, L., de Pak, G., Chang, N. Y., ... Deen, J. L. (2012). The burden of Invasive Bacterial Infections in Pemba, Zanibar. PLoS One, 7(2), 1-9. [e30350]. https://doi.org/10.1371/journal.pone.0030350
    Thriemer, Kamala ; Ley, Benedikt ; Ame, Shaali ; von Seidlein, Lorenz ; de Pak, Giok ; Chang, Na Yoon ; Hashim, Ramadhan ; Schmied, Wolfgang Hellmut ; BuschClara, Clara Jana Lui ; Nixon, Shanette ; Morrissey, Anne ; Puri, Mahesh K. ; Ali, Mohammad ; Ochiai, R. Leon ; Wierzba, Thomas ; Jiddawi, Mohammad S. ; Clemens, John D. ; Ali, Said M. ; Deen, Jaqueline L. / The burden of Invasive Bacterial Infections in Pemba, Zanibar. In: PLoS One. 2012 ; Vol. 7, No. 2. pp. 1-9.
    @article{97f04ff00bdc4923b87d9abfd3bb6d2e,
    title = "The burden of Invasive Bacterial Infections in Pemba, Zanibar",
    abstract = "Background: We conducted a surveillance study to determine the leading causes of bloodstream infection in febrile patients seeking treatment at three district hospitals in Pemba Island, Zanzibar, Tanzania, an area with low malaria transmission. Methods: All patients above two months of age presenting to hospital with fever were screened, and blood was collected for microbiologic culture and malaria testing. Bacterial sepsis and malaria crude incidence rates were calculated for a one-year period and were adjusted for study participation and diagnostic sensitivity of blood culture. Results: Blood culture was performed on 2,209 patients. Among them, 166 (8{\%}) samples yielded bacterial growth; 87 (4{\%}) were considered as likely contaminants; and 79 (4{\%}) as pathogenic bacteria. The most frequent pathogenic bacteria isolated were Salmonella Typhi (n = 46; 58{\%}), followed by Streptococcus pneumoniae (n = 12; 15{\%}). The crude bacteremia rate was 6/100,000 but when adjusted for potentially missed cases the rate may be as high as 163/100,000. Crude and adjusted rates for S. Typhi infections and malaria were 4 and 110/100,000 and 4 and 47/100,000, respectively. Twenty three (51{\%}), 22 (49{\%}) and 22 (49{\%}) of the S.Typhi isolates were found to be resistant toward ampicillin, chloramphenicol and cotrimoxazole, respectively. Multidrug resistance (MDR) against the three antimicrobials was detected in 42{\%} of the isolates. Conclusions: In the presence of very low malaria incidence we found high rates of S. Typhi and S. pneumoniae infections on Pemba Island, Zanzibar. Preventive measures such as vaccination could reduce the febrile disease burden.",
    keywords = "amoxicillin plus clavulanic acid, ampicillin, cefazolin, ceftazidime, ceftriaxone, chloramphenicol, ciprofloxacin, cotrimoxazole, gentamicin, nalidixic acid, antiinfective agent, antibiotic sensitivity, article, bacterial growth, bacterial infection, blood culture, fever, human, incidence, malaria, malaria falciparum, microbiological examination, multidrug resistance, Salmonella typhi, Streptococcus pneumoniae, Tanzania, adolescent, adult, age distribution, bacteremia, bacterium, child, drug effect, geography, hospital, microbiology, preschool child, statistics, Adolescent, Adult, Age Distribution, Anti-Bacterial Agents, Bacteremia, Bacteria, Bacterial Infections, Child, Child, Preschool, Geography, Hospitals, Humans, Incidence, Malaria, Microbial Sensitivity Tests",
    author = "Kamala Thriemer and Benedikt Ley and Shaali Ame and {von Seidlein}, Lorenz and {de Pak}, Giok and Chang, {Na Yoon} and Ramadhan Hashim and Schmied, {Wolfgang Hellmut} and BuschClara, {Clara Jana Lui} and Shanette Nixon and Anne Morrissey and Puri, {Mahesh K.} and Mohammad Ali and Ochiai, {R. Leon} and Thomas Wierzba and Jiddawi, {Mohammad S.} and Clemens, {John D.} and Ali, {Said M.} and Deen, {Jaqueline L.}",
    year = "2012",
    month = "2",
    day = "17",
    doi = "10.1371/journal.pone.0030350",
    language = "English",
    volume = "7",
    pages = "1--9",
    journal = "PLoS One",
    issn = "1932-6203",
    publisher = "Public Library of Science (PLoS)",
    number = "2",

    }

    Thriemer, K, Ley, B, Ame, S, von Seidlein, L, de Pak, G, Chang, NY, Hashim, R, Schmied, WH, BuschClara, CJL, Nixon, S, Morrissey, A, Puri, MK, Ali, M, Ochiai, RL, Wierzba, T, Jiddawi, MS, Clemens, JD, Ali, SM & Deen, JL 2012, 'The burden of Invasive Bacterial Infections in Pemba, Zanibar', PLoS One, vol. 7, no. 2, e30350, pp. 1-9. https://doi.org/10.1371/journal.pone.0030350

    The burden of Invasive Bacterial Infections in Pemba, Zanibar. / Thriemer, Kamala; Ley, Benedikt; Ame, Shaali; von Seidlein, Lorenz; de Pak, Giok; Chang, Na Yoon; Hashim, Ramadhan; Schmied, Wolfgang Hellmut; BuschClara, Clara Jana Lui; Nixon, Shanette; Morrissey, Anne; Puri, Mahesh K.; Ali, Mohammad; Ochiai, R. Leon; Wierzba, Thomas; Jiddawi, Mohammad S.; Clemens, John D.; Ali, Said M.; Deen, Jaqueline L.

    In: PLoS One, Vol. 7, No. 2, e30350, 17.02.2012, p. 1-9.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - The burden of Invasive Bacterial Infections in Pemba, Zanibar

    AU - Thriemer, Kamala

    AU - Ley, Benedikt

    AU - Ame, Shaali

    AU - von Seidlein, Lorenz

    AU - de Pak, Giok

    AU - Chang, Na Yoon

    AU - Hashim, Ramadhan

    AU - Schmied, Wolfgang Hellmut

    AU - BuschClara, Clara Jana Lui

    AU - Nixon, Shanette

    AU - Morrissey, Anne

    AU - Puri, Mahesh K.

    AU - Ali, Mohammad

    AU - Ochiai, R. Leon

    AU - Wierzba, Thomas

    AU - Jiddawi, Mohammad S.

    AU - Clemens, John D.

    AU - Ali, Said M.

    AU - Deen, Jaqueline L.

    PY - 2012/2/17

    Y1 - 2012/2/17

    N2 - Background: We conducted a surveillance study to determine the leading causes of bloodstream infection in febrile patients seeking treatment at three district hospitals in Pemba Island, Zanzibar, Tanzania, an area with low malaria transmission. Methods: All patients above two months of age presenting to hospital with fever were screened, and blood was collected for microbiologic culture and malaria testing. Bacterial sepsis and malaria crude incidence rates were calculated for a one-year period and were adjusted for study participation and diagnostic sensitivity of blood culture. Results: Blood culture was performed on 2,209 patients. Among them, 166 (8%) samples yielded bacterial growth; 87 (4%) were considered as likely contaminants; and 79 (4%) as pathogenic bacteria. The most frequent pathogenic bacteria isolated were Salmonella Typhi (n = 46; 58%), followed by Streptococcus pneumoniae (n = 12; 15%). The crude bacteremia rate was 6/100,000 but when adjusted for potentially missed cases the rate may be as high as 163/100,000. Crude and adjusted rates for S. Typhi infections and malaria were 4 and 110/100,000 and 4 and 47/100,000, respectively. Twenty three (51%), 22 (49%) and 22 (49%) of the S.Typhi isolates were found to be resistant toward ampicillin, chloramphenicol and cotrimoxazole, respectively. Multidrug resistance (MDR) against the three antimicrobials was detected in 42% of the isolates. Conclusions: In the presence of very low malaria incidence we found high rates of S. Typhi and S. pneumoniae infections on Pemba Island, Zanzibar. Preventive measures such as vaccination could reduce the febrile disease burden.

    AB - Background: We conducted a surveillance study to determine the leading causes of bloodstream infection in febrile patients seeking treatment at three district hospitals in Pemba Island, Zanzibar, Tanzania, an area with low malaria transmission. Methods: All patients above two months of age presenting to hospital with fever were screened, and blood was collected for microbiologic culture and malaria testing. Bacterial sepsis and malaria crude incidence rates were calculated for a one-year period and were adjusted for study participation and diagnostic sensitivity of blood culture. Results: Blood culture was performed on 2,209 patients. Among them, 166 (8%) samples yielded bacterial growth; 87 (4%) were considered as likely contaminants; and 79 (4%) as pathogenic bacteria. The most frequent pathogenic bacteria isolated were Salmonella Typhi (n = 46; 58%), followed by Streptococcus pneumoniae (n = 12; 15%). The crude bacteremia rate was 6/100,000 but when adjusted for potentially missed cases the rate may be as high as 163/100,000. Crude and adjusted rates for S. Typhi infections and malaria were 4 and 110/100,000 and 4 and 47/100,000, respectively. Twenty three (51%), 22 (49%) and 22 (49%) of the S.Typhi isolates were found to be resistant toward ampicillin, chloramphenicol and cotrimoxazole, respectively. Multidrug resistance (MDR) against the three antimicrobials was detected in 42% of the isolates. Conclusions: In the presence of very low malaria incidence we found high rates of S. Typhi and S. pneumoniae infections on Pemba Island, Zanzibar. Preventive measures such as vaccination could reduce the febrile disease burden.

    KW - amoxicillin plus clavulanic acid

    KW - ampicillin

    KW - cefazolin

    KW - ceftazidime

    KW - ceftriaxone

    KW - chloramphenicol

    KW - ciprofloxacin

    KW - cotrimoxazole

    KW - gentamicin

    KW - nalidixic acid

    KW - antiinfective agent

    KW - antibiotic sensitivity

    KW - article

    KW - bacterial growth

    KW - bacterial infection

    KW - blood culture

    KW - fever

    KW - human

    KW - incidence

    KW - malaria

    KW - malaria falciparum

    KW - microbiological examination

    KW - multidrug resistance

    KW - Salmonella typhi

    KW - Streptococcus pneumoniae

    KW - Tanzania

    KW - adolescent

    KW - adult

    KW - age distribution

    KW - bacteremia

    KW - bacterium

    KW - child

    KW - drug effect

    KW - geography

    KW - hospital

    KW - microbiology

    KW - preschool child

    KW - statistics

    KW - Adolescent

    KW - Adult

    KW - Age Distribution

    KW - Anti-Bacterial Agents

    KW - Bacteremia

    KW - Bacteria

    KW - Bacterial Infections

    KW - Child

    KW - Child, Preschool

    KW - Geography

    KW - Hospitals

    KW - Humans

    KW - Incidence

    KW - Malaria

    KW - Microbial Sensitivity Tests

    UR - http://www.scopus.com/inward/record.url?scp=84857203660&partnerID=8YFLogxK

    U2 - 10.1371/journal.pone.0030350

    DO - 10.1371/journal.pone.0030350

    M3 - Article

    VL - 7

    SP - 1

    EP - 9

    JO - PLoS One

    JF - PLoS One

    SN - 1932-6203

    IS - 2

    M1 - e30350

    ER -