• R P Reed, F O Wegerhoff, and A D Rothberg.
• Shongwe Mission Hospital, University of the Witwatersrand, Johannesburg, Republic of South Africa.
• Ann Trop Paediatr. 1996 Mar 1; 16 (1): 61-8.

AbstractDuring a 5-month study period, 323 of 863 (37.5%) children below 5 years of age admitted to Shongwe Mission Hospital in rural South Africa were malnourished, two-thirds severely so. The incidence of bacteraemia in malnourished children was 9.6%, 11.8% in those severely malnourished and 5.8% in nutritional dwarfs. The predominant organisms retrieved were Gram-negative enteric bacilli (48.5%). Amongst the severely malnourished, who empirically receive intravenous ampicillin and gentamicin, 95.8% of all isolates were sensitive to this antibiotic combination. The case fatality rate of severely malnourished bacteraemic children was 20.8%. In malnutrition categories overall, the case fatality rate for bacteraemic children (22.6%) was significantly greater than in those without bacteraemia (9.3%). In hospitals with limited resources, full identification of bacteria may not be necessary, provided that regular surveillance for emerging resistance is conducted.

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