Original Research

Paediatric Enterobacteriaceae infections in hospitalised children in Durban, KwaZulu-Natal

Harshna Krishinchand, Kimesh Naidoo, Prasha Mahabeer, Moherndran Archary
Southern African Journal of Infectious Diseases | Vol 36, No 1 | a279 | DOI: https://doi.org/10.4102/sajid.v36i1.279 | © 2021 Harshna Krishinchand, Kimesh Naidoo, Prasha Mahabeer, Moherndran Archary | This work is licensed under CC Attribution 4.0
Submitted: 09 February 2021 | Published: 30 July 2021

About the author(s)

Harshna Krishinchand, Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Kimesh Naidoo, Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Department of Paediatrics, King Edward VIII Hospital, Durban, South Africa
Prasha Mahabeer, Department of Microbiology, King Edward VIII Hospital, Durban, South Africa; and, Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Moherndran Archary, Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; and, Department of Paediatrics and Child Health, King Edward VIII Hospital, Durban, South Africa


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Abstract

Background: Community-acquired Gram-negative Enterobacteriaceae infections in malnourished and HIV-infected hospitalised children are not well documented and are of concern because of increasing antibiotic resistance and limited available treatment options. This study describes the clinical characteristics and outcomes of hospitalised children with positive Enterobacteriaceae cultures.

Method: A retrospective chart review of children with Gram-negative Enterobacteriaceae infections was performed in King Edward VIII Hospital, a referral hospital in Durban, KwaZulu-Natal. Standard descriptive and analytical statistics, including regression analysis, were performed to determine the clinical characteristics associated with Enterobacteriaceae infections in children hospitalised in the study period.

Results: Of all hospitalised children in the study period, 207 (3.5%) had positive cultures for Enterobacteriaceae isolates, with Escherichia coli 109 (44.5%) and Klebsiella spp. 59 (24.1%) making up most of the infections. Urine (126; 58%) followed by stool (34; 14.8%) and blood (35; 14.0%) were the commonest samples that yielded positive cultures. Diarrhoeal hospitalisations especially posed a higher risk for Enterobacteriaceae infections. Severe acutely malnourished and HIV-infected children were at higher risk. These comorbidities were independently associated with an increased risk of Enterobacteriaceae infection. Prolonged hospitalisation and increased risk of death were also associated with Enterobacteriaceae infection.

Conclusion: Enterobacteriaceae infections were common in hospitalised children and posed an increased risk, especially in malnourished and HIV-infected children. Further studies investigating the relationships between diarrhoea, urinary tract infections and Enterobacteriaceae infections are needed.


Keywords

paediatric; Enterobacteriaceae infections; HIV; malnutrition; hospitalisation

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