Bacteraemia in children in the south-western Cape. A hospital-based survey

Cotton, M. F. ; Burger, P. J. ; Bodenstein, W. J. M. (1992-1)

CITATION: Cotton, M.F., Burger, P.J. & Bodenstein, W.J.M. 1992. Bacteraemia in children in the south-western Cape. A hospital-based survey. S Afr Med J, 81(1):87-90.

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During 1989, of the 8524 children admitted to the paediatric wards of Tygerberg Hospital, 165 (1,96%) had bacteraemia. The incidence of community-acquired bacteraemias was 1,6% and that of nosocomial bacteraemias 0,5%. The most important community-acquired isolates were Streptococcus pneumoniae, Staphylococcus aureus and Neisseria meningitidis. The most important nosocomial isolates were Klebsiella and Salmonella spp. Both bacteraemia (relative risk (RR) = 2,08) and severe malnutrition (RR = 3,01) were more common in black patients. Overall, severe malnutrition was more common than mild malnutrition or a normal nutritional status in bacteraemic patients (odds radio (OR) = 3,17). Nineteen patients with bacteraemia died, there was a significantly higher case-fatality rate in patients with extreme malnutrition (P = 0,03; OR = 3,7). Gram-negative bacilli were found more commonly in patients with extreme malnutrition (OR = 5,4) and patients with nosocomial bacteraemia (OR = 4,6). Three of 39 patients (7,6%) with nosocomial bacteraemia had suppurative thrombophlebitis.

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