BACTEREMIA IN MALNOURISHED RURAL AFRICAN CHILDREN

During a 5-month study period, 323 of 863 (37.5%) children below 5 yea rs of age admitted to Shongwe Mission Hospital in rural South Africa w ere malnourished, two-thirds severely so. The incidence of bacteraemia in malnourished children was 9.6%, 11.8% in those severely malnourish ed and 5.8% in nutritional dwarfs. The predominant organisms retrieved were Gram-negative enteric bacilli (48.5%). Amongst the severely maln ourished, who empirically receive intravenous ampicillin and gentamici n, 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 th ose without bacteraemia (9.3%). In hospitals with limited resources, f ull identification of bacteria may not be necessary, provided that reg ular surveillance for emerging resistance is conducted.