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Bacterial aetiology and outcome in children with severe pneumonia in Uganda

R Nantanda1, H Hildenwall, S Peterson

  • 1Department of Paediatrics & Child Health, Makerere University Medical School, Kampala, Uganda. rnantanda@yahoo.com

Annals of Tropical Paediatrics
|November 22, 2008
PubMed

Insights

Severe pneumonia in Ugandan children is often caused by Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae. Antibiotic resistance is a growing concern, impacting treatment outcomes for this vulnerable population.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Pneumonia is a leading cause of death in children under five globally and in Uganda.
  • Increasing antibiotic resistance poses a significant threat to managing childhood pneumonia.

Purpose of the Study:

  • To investigate the bacterial causes of severe pneumonia in children aged 2-59 months.
  • To determine antimicrobial susceptibility patterns and treatment outcomes.
  • To identify risk factors for mortality in severe pediatric pneumonia cases in Uganda.

Main Methods:

  • Prospective study of 157 children with severe pneumonia at Mulago Hospital, Uganda.
  • Collection of blood and sputum for bacterial culture and analysis.
  • Clinical classification of pneumonia severity and 7-day follow-up for outcomes.

Main Results:

  • Staphylococcus aureus and Streptococcus pneumoniae were the most common causes of bacteremia.
  • Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella species were frequently isolated from sputum.
  • High resistance rates were observed for Staphylococcus aureus and Haemophilus influenzae against common antibiotics, while Streptococcus pneumoniae remained sensitive to chloramphenicol.

Conclusions:

  • Key bacterial pathogens include S. aureus, S. pneumoniae, and H. influenzae.
  • Current first-line antibiotic chloramphenicol shows variable efficacy due to emerging resistance.
  • Severe malnutrition, hypoxemia, and very severe pneumonia are critical predictors of mortality.
Abstract

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