Related Experiment Videos
Bacteraemia in cerebral malaria
G Enwere1, M B Van Hensbroek, R Adegbola
1Royal Victoria Hospital, Banjul, The Gambia Laboratory, Fajara, The Gambia.
Abstract:
As part of a treatment trial of cerebral malaria, blood cultures were done in 276 Gambian children, aged between 1 and 9 years, with cerebral malaria. Fourteen (5%) of these were positive. The organisms isolated were Staphylococcus aureus (6), coliforms (4), Pseudomonas spp. (2), Salmonella spp. (1) and Streptococcus spp. (1). Thirteen of these children survived, most without appropriate antibiotic treatment. Most of the retrieved organisms were therefore suspected to be contaminants. Bacteraemia complicating cerebral malaria is not common in The Gambia, and routine antibiotic treatment of children with cerebral malaria is not warranted.
Insights
In Gambian children with cerebral malaria, blood cultures rarely showed bacterial infections (5%). Most identified bacteria were likely contaminants, suggesting routine antibiotics are not needed for cerebral malaria treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Tropical Medicine
Background:
- Cerebral malaria is a severe complication of Plasmodium falciparum infection.
- Bacterial co-infections can complicate malaria, but their prevalence in cerebral malaria is not well-established in all regions.
- Understanding the role of bacterial bloodstream infections in cerebral malaria is crucial for guiding treatment strategies.
Purpose of the Study:
- To investigate the incidence and types of bacterial bloodstream infections in Gambian children diagnosed with cerebral malaria.
- To determine if bacterial infections commonly complicate cerebral malaria in this population.
- To assess the potential need for routine antibiotic therapy in children with cerebral malaria.
Main Methods:
- Blood cultures were performed on 276 children aged 1-9 years with cerebral malaria in The Gambia.
- Organisms isolated from positive blood cultures were identified.
- Patient outcomes, including survival and antibiotic treatment, were noted.
Main Results:
- Blood cultures were positive in 14 (5%) of the 276 children.
- The most common isolates included Staphylococcus aureus, coliforms, Pseudomonas spp., Salmonella spp., and Streptococcus spp.
- Thirteen of the 14 children with positive blood cultures survived, many without specific antibiotic treatment, suggesting potential contamination.
Conclusions:
- Bacteraemia complicating cerebral malaria appears uncommon in Gambian children.
- The majority of positive blood cultures in this study may represent contaminants.
- Routine antibiotic treatment for children with cerebral malaria in The Gambia is not currently warranted based on these findings.