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Julia Rhodes Joseph A. Hyder Leonard F. Peruski Cindy Fisher Possawat Jorakate Anek Kaewpan Surang Dejsirilert Somsak Thamthitiwat Sonja J. Olsen Scott F. Dowell Somrak Chantra Kittisak Tanwisaid Susan A. Maloney Henry C. Baggett 《The American journal of tropical medicine and hygiene》2010,83(2):301-306
No studies have quantified the impact of pre-culture antibiotic use on the recovery of individual blood-borne pathogens or on population-level incidence estimates for Streptococcus pneumoniae. We conducted bloodstream infection surveillance in Thailand during November 2005–June 2008. Pre-culture antibiotic use was assessed by reported use and by serum antimicrobial activity. Of 35,639 patient blood cultures, 27% had reported pre-culture antibiotic use and 24% (of 24,538 tested) had serum antimicrobial activity. Pathogen isolation was half as common in patients with versus without antibiotic use; S. pneumoniae isolation was 4- to 9-fold less common (0.09% versus 0.37% by reported antibiotic use; 0.05% versus 0.45% by serum antimicrobial activity, P < 0.01). Pre-culture antibiotic use by serum antimicrobial activity reduced pneumococcal bacteremia incidence by 32% overall and 39% in children < 5 years of age. Our findings highlight the limitations of culture-based detection methods to estimate invasive pneumococcal disease incidence in settings where pre-culture antibiotic use is common. 相似文献
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Bhengsri S Baggett HC Jorakate P Kaewpan A Prapasiri P Naorat S Thamthitiwat S Tanwisaid K Chantra S Salika P Dejsirilert S Peruski LF Maloney SA 《The American journal of tropical medicine and hygiene》2011,85(1):117-120
Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in northeastern Thailand. Population-based disease burden estimates are lacking and limited data on melioidosis exist from other regions of the country. Using active, population-based surveillance, we measured the incidence of bacteremic melioidosis in the provinces of Sa Kaeo (eastern Thailand) and Nakhon Phanom (northeastern Thailand) during 2006-2008. The average annual incidence in Sa Kaeo and Nakhon Phanom per 100,000 persons was 4.9 (95% confidence interval [CI] = 3.9-6.1) and 14.9 (95% CI = 13.3-16.6). The respective population mortality rates were 1.9 (95% CI = 1.3-2.8) and 4.4 (95% CI = 3.6-5.3) per 100,000. The case-fatality proportion was 36% among those with known outcome. Our findings document a high incidence and case fatality proportion of bacteremic melioidosis in Thailand, including a region not traditionally considered highly endemic, and have potential implications for clinical management and health policy. 相似文献
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H. C. Baggett J. Rhodes S. Dejsirilert P. Salika T. Wansom P. Jorakate A. Kaewpan S. J. Olsen S. A. Maloney L. F. Peruski 《European journal of clinical microbiology & infectious diseases》2012,31(5):753-756
The purpose of this investigation was to enhance the detection of pneumococcal bacteremia cases using the Binax NOW? immunochromatographic
test (ICT) on blood culture broth as part of surveillance in two rural Thailand provinces. Blood cultures were collected as
clinically indicated from hospitalized patients. ICT was performed on broth from culture bottles flagged as positive by BactT/ALERT?
(alarm-positive) but which failed to grow organisms on subculture. During the period May 2005–June 2007, ICT was positive
on 43 (24%) of 182 alarm-positive blood cultures with no growth on subculture. Compared to pneumococcal bacteremia cases confirmed
by culture, cases detected only by ICT had a longer median time from culture collection to incubation and a longer median
time from alarm positivity to subculture, and were more likely to be from patients pretreated with antibiotics. In a subsequent
surveillance period (July 2007–December 2009), ICT continued to detect additional pneumococcal cases, but in a lower proportion
of samples (7 of 221, 3.2%). Recently, as part of a separate study, ICT applied to uninoculated blood culture broth produced
weak-positive results, mandating caution if testing broth from patient blood cultures. The antigen testing of blood culture
broth appears to enhance the detection of pneumococcal bacteremia, but a controlled evaluation is needed. 相似文献
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