A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy.

Journal Article (Journal Article)

The etiology of bloodstream infections (BSIs) in febrile (> or =37.5 degrees C) adults (> or =18 years old) in one Malawi hospital were determined during August and September 1997. After clinical evaluation, blood was drawn for comprehensive culture, human immunodeficiency virus (HIV) type 1 testing, and malaria smear. Of 233 patients, 173 (74%) were HIV-1 infected, and 70 (30%) had BSI. BSI pathogens included 25 (33%) Streptococcus pneumoniae and 21 (28%) Mycobacterium tuberculosis. Nine patients (4%) had malaria parasitemia. BSIs were more likely in HIV-1-positive than in -negative patients (62/173 vs. 8/60, P<.01). Clinical predictors of BSI included HIV-1 infection and altered mental status. Mortality among inpatients with BSI was higher than among those without BSI (P<.001). In conclusion, S. pneumoniae and M. tuberculosis are frequent causes of BSI in febrile adults. Similar surveys, performed periodically in developing countries, may assist in the identification of clinical predictors of BSI and in planning appropriate therapy.

Full Text

Duke Authors

Cited Authors

  • Archibald, LK; McDonald, LC; Nwanyanwu, O; Kazembe, P; Dobbie, H; Tokars, J; Reller, LB; Jarvis, WR

Published Date

  • April 2000

Published In

Volume / Issue

  • 181 / 4

Start / End Page

  • 1414 - 1420

PubMed ID

  • 10762572

International Standard Serial Number (ISSN)

  • 0022-1899

Digital Object Identifier (DOI)

  • 10.1086/315367


  • eng

Conference Location

  • United States