Table 1.
Demographic and clinical characteristics of 2,058 patients and the percentage with antibiotic activity detected in their urine in the retrospective examination of inpatients in Vientiane and those with unexplained fever at Phalanxay
| Study | % Male | Age/years* | % < 15 years old | No. of urine specimens | No. (%) (95% confidence interval [CI]) with any antimicrobial activity in urine | No. (%) (95%CI) urine samples containing antimicrobial activity according to species of target organism | ||
|---|---|---|---|---|---|---|---|---|
| E. coli | B. stearothermophilus | S. pyogenes | ||||||
| All in Vientiane | 59.1 | 26 (0.005–93)1842 | 23.81842 | 1,844 | 916 (49.7) (47.4–52.0) | 443/1840 (24.1) (22.1–26.0) | 805/1839 (43.8) (41.5–46.0) | 613/1840 (33.3) (31.2–35.5) |
| Central nervous system (CNS) infections† | 64.5 | 27 (0.01–84) | 23.4 | 414 | 235 (56.8) (52.0–61.5) | 154/410 (37.6) (32.9–42.3) | 212/409 (51.8) (47.0–56.7) | 189/410 (46.1) (41.3–50.9) |
| Typhus suspected without suspected CNS infection‡ | 60.8 | 29 (0.33–85) | 6.0 | 663 | 246 (37.1) (33.4–40.8) | 106 (16.0) (13.2–18.8) | 202 (30.5) (27.0–34.0) | 145 (21.9) (18.7–25.0) |
| Community-acquired septicemia alone suspected§ | 54.9 | 22 (0.005–93)761 | 39.3761 | 763 | 433 (56.8) (53.3–60.3) | 181 (23.7) (20.7–26.7) | 389 (51.0) (47.4–54.5) | 277 (36.3) (32.9–39.7) |
| All who had blood cultures taken¶ | 58.7 | 26 (0.005–93)1812 | 24.11812 | 1814 | 905 (49.9) (47.6–52.2) | 433/1810 (23.9) (22.0–25.9) | 796/1809 (44.0) (41.7–46.3) | 605/1810 (33.4) (31.3–35.6) |
| All adults | 59.1 | – | – | 1,404 | 653 (46.5) (43.9–49.1) | 317/1401 (22.6) (20.4–24.8) | 562/1399 (40.2) (37.6–42.7) | 419/1400 (29.9) (27.5–32.3) |
| All children | 58.9 | – | – | 438 | 263 (60.0) (55.5–64.6) | 126/437 (28.8) (24.6–33.1) | 243/438 (55.5) (50.8–60.1) | 194 (44.3) (39.6–48.9) |
| Phalanxay‖ | 57.5 | 15 (3–80) | 50 | 214 | 81 (37.9) (31.4–44.4) | 29 (13.6) (9.0–18.1) | 67 (31.3) (25.1–37.5) | 44 (20.7) (15.2–26.1)213 |
| All adults | 57.0 | – | – | 107 | 43 (40.2) (30.9–49.5) | 16 (15.0) (8.2–27.7) | 36 (33.6) (24.7–42.6) | 22 (20.8) (13.0–28.5)106 |
| All children | 57.9 | – | – | 107 | 38 (35.5) (26.4–44.6) | 13 (12.2) (6.0–18.3) | 31 (29.0) (20.4–37.6) | 22 (20.6) (12.9–28.2) |
Denominators are only shown if there are missing values. Number (%) or * Median (range).
Any patient with clinically suspected community-acquired infection of the CNS without contraindications to lumbar puncture in Vientiane. Clinically significant organisms were cultured from 33 of 414 (8.0%) patients who had cerebrospinal fluid (CSF) culture (S. pneumoniae [N = 8], S. suis [N = 1], K. pneumoniae [N = 1], C. neoformans [N = 20], and Mycobacterium tuberculosis [N = 3]). Polymerase chain reaction (20 and Mayxay M, unpublished) assays for S. pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b in CSF were positive in an additional six patients with S. pneumoniae and two each with N. meningitidis and H. influenzae, giving a total of 43 of 414 (10.4%) of patients having proven bacterial/fungal meningitis.
Any patient with clinically suspected typhus, but without suspected CNS infection, in Vientiane. Thirty-eight (5.7%) had positive blood cultures (growing S. typhi [N = 19], E. coli [N = 9], B. pseudomallei [N = 4], K. pneumoniae [N = 2], Salmonella spp. [N = 1], S. pyogenes [N = 1], S. aureus [N = 1], and Aeromonas hydrophilia [N = 1]).
Any patient with clinically suspected community-acquired septicemia in Vientiane.
Clinically significant organisms were cultured from 109 of 1,844 (5.9%) patients who had blood cultures taken—Salmonella enterica serovar typhi (N = 34), E. coli (N = 23), Burkholderia pseudomallei (N = 9), S. aureus (N = 8), Klebsiella pneumoniae (N = 6), Salmonella spp. (N = 6), S. pyogenes (N = 3), S. pneumoniae (N = 9), A. hydrophila (N = 1), Edwardsiella tarda (N = 1), Group B Streptococcus (N = 1), S. suis (N = 1), Neisseria meningitidis (N = 1), Cryptococcus neoformans (N = 4), and Penicillium marneffei (N = 2).
Any patient, presenting at Phalanxay District Hospital, who the admitting physician thought may have malaria and performed slide microscopy and/or malaria rapid diagnostic test for P. falciparum (Paracheck, Orchid Industries, Goa, India) that were negative.