BACTEREMIA AND MENINGITIS AMONG HOSPITAL PATIENTS WITH DIARRHEA

To characterize bacteraemia and meningitis in diarrhoeal patients, the records of 3395 blood cultures and 120 cerebrospinal fluid (CSF) cult ures from 6132 patients admitted with diarrhoea to the Clinical Resear ch Centre of the International Centre for Diarrhoeal Disease Research, Bangladesh during 1989 were analysed. Microorganisms were isolated fr om 12% (417 of 3395) of blood cultures and 9% (11 of 120) of CSF cultu res. Children below 5 years of age represented 80% of all patients who had blood cultures and 82% of those who had CSF cultures made. The nu tritional status was significantly lower in patients who had positive blood cultures than in those who had negative cultures. 23% (97 of 417 ) of patients with positive blood cultures and 45% (5 of 11) with posi tive CSF cultures died. Deaths occurred twice as often among patients who had organisms isolated than among those who had no organisms isola ted from blood cultures. The organisms isolated from blood cultures wh ich predicted most deaths were Pseudomonas aeruginosa, Neisseria menin gitidis, Escherichia coli and Klebsiella sp., and they were multiresis tant. We conclude that bacteraemia and meningitis remain serious compl ications associated with diarrhoea, especially in malnourished childre n; the therapeutic problem is further complicated by multiple drug res istance of the isolates.