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Saito, Nobuo, Solante, Rontgene M., Guzman, Ferdinand D., Telan, Elizabeth O., Umipig, Dorcas V., Calayo, Joy P., Frayco, Carina H., Lazaro, Jezreel C., Ribo, Maricel R., Dimapilis, Alexis Q., Dimapilis, Virginia O., Villanueva, Annavi M., Mauhay, Jaira L., Suzuki, Motoi, Yasunami, Michio, Koizumi, Nobuo, Kitashoji, Emi, Sakashita, Kentaro, Yasuda, Ikkoh, Nishiyama, Akira, Smith, Chris, Ariyoshi, Koya and Parry, Christopher (2022) 'A prospective observational study of community-acquired bacterial bloodstream infections in Metro Manila, the Philippines'. PLoS Neglected Tropical Diseases, Vol 16, Issue 5, e0010414.
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Abstract
Community-acquired bacterial bloodstream infections are caused by diverse pathogens with changing antimicrobial-resistance patterns. In low-middle income countries in Southeast Asia, where dengue fever is endemic and a leading cause of fever, limited information is available about bacterial bloodstream infections due to challenges of implementing a blood culture service. This study describes bacterial bloodstream pathogens and antimicrobial-resistance patterns in Metro Manila, the Philippines. We aimed to identify the proportion of patients with a positive blood culture, the bacteria isolated and their antimicrobial resistance patterns, and the clinical characteristics of these patients, in this dengue endemic area. We conducted a prospective observational study in a single hospital enrolling febrile patients clinically suspected of having a community-acquired bacterial bloodstream infection between 1st July 2015 and 30th June 2019. Each patient had a blood culture and additional diagnostic tests according to their clinical presentation. We enrolled 1315 patients and a significant positive blood culture was found in 77 (5.9%) including Staphylococcus aureus (n=20), Salmonella enterica Typhi (n=18), Escherichia coli (n=16), Streptococcus pneumoniae (n=3) and Burkholderia pseudomallei (n=2). Thirty-four patients had meningococcal disease diagnosed by culture (n=8) or blood PCR (n=26). Additional confirmed diagnoses included leptospirosis (n=177), dengue virus infection (n=159) and respiratory diphtheria (n=50). There were 79 (6.0%, 95%CI 4.8%−7.4%) patients who died within 28 days of enrollment. Patients with a positive blood culture were significantly more likely to die than patients with negative culture (15.2 % vs 4.4 %, P<0.01). Among S. aureus isolates, 11/20 (55%) were methicillin-resistant (MRSA) and ST30 : USA1100 was dominant sequence type (88.9%). Antimicrobial-susceptibility was well preserved in S. enterica Typhi. Among hospitalized patients with clinically suspected community-acquired bacterial bloodstream infection in Metro Manila, the Philippines, 5.9% had a blood culture confirmed infection of whom 15.6% died. S. aureus, including a significant number of MRSA (USA1100 clones), S. enterica Typhi, E.coli and Neisseria meningitidis were frequently identified pathogens.
| Item Type: | Article |
|---|---|
| Subjects: | QW Microbiology and Immunology > QW 45 Microbial drug resistance. General or not elsewhere classified. WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 200 Bacterial infections (General or not elsewhere classified) WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 240 Bacteremia. Sepsis. Toxemias WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 120 Hematologic diseases (General or not elsewhere classified) |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1371/journal.pntd.0010414 |
| Depositing User: | Mary Creegan |
| Date Deposited: | 09 Jun 2022 13:30 |
| Last Modified: | 09 Jun 2022 13:30 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/20475 |
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