OBJECTIVES: To identify clinical and laboratory predictors of bacteremia in infants with diarrhea and systemic inflammatory response syndrome and to analyze their outcome. STUDY DESIGN: Retrospective, case-control study. SETTING: The Special Care Ward of the Dhaka Hospital of the International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh. PATIENTS: All the infants (n = 90) admitted to the Special Care Ward between May 2005 and April 2006 who had a blood culture, full peripheral blood count, and serum C-reactive protein performed were included in the study. Infant with systemic inflammatory response syndrome with confirmed bacteremia (n = 18) constituted cases, and those with systemic inflammatory response syndrome but negative blood culture (n = 72) constituted the controls. RESULTS: The following features were analyzed by comparing the two groups: absent or uncountable peripheral pulses, hypothermia, sclerema, altered mental status, white blood cell count, serum C-reactive protein, total protein concentrations, and outcome. The case-fatality rate was significantly higher among bacteremic infants compared with those without bacteremia (33% vs. 6%, p < .01). In the univariate model, sclerema (56% vs. 28%, p = .05), hyperglycemia (28% vs. 6%, p < .01), immature neutrophils [3.5 (00, 6.5) vs. 0.0 (0.0, 3.25); p = .02], higher C-reactive protein [2.7 (1.2, 7.4) vs. 1.8 (0.5, 4.2); p = .02], and lower serum total protein (51.1 +/- 14.1 vs. 57.6 +/- 12.2; p = .05) were identified as potential predictors of bacteremia. However, in the logistic regression analysis, after adjusting for confounders, only hypothermia (odds ratio = 6.4, 95% confidence Interval, 1.6-25.9; p = .01) and absent or uncountable peripheral pulse (odds ratio, 12.4, 95% confidence interval, 1.9-83.4; p < .01) remained significant independent predictors of bacteremia. CONCLUSIONS: Our data suggest that, in infants presenting with diarrhea and systemic inflammatory response syndrome, coexistence of hypothermia and absent or uncountable peripheral pulse is strongly associated with bacteremia. Bacteremia in this patient group is associated with high case-fatality rates.
OBJECTIVES: To identify clinical and laboratory predictors of bacteremia in infants with diarrhea and systemic inflammatory response syndrome and to analyze their outcome. STUDY DESIGN: Retrospective, case-control study. SETTING: The Special Care Ward of the Dhaka Hospital of the International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh. PATIENTS: All the infants (n = 90) admitted to the Special Care Ward between May 2005 and April 2006 who had a blood culture, full peripheral blood count, and serum C-reactive protein performed were included in the study. Infant with systemic inflammatory response syndrome with confirmed bacteremia (n = 18) constituted cases, and those with systemic inflammatory response syndrome but negative blood culture (n = 72) constituted the controls. RESULTS: The following features were analyzed by comparing the two groups: absent or uncountable peripheral pulses, hypothermia, sclerema, altered mental status, white blood cell count, serum C-reactive protein, total protein concentrations, and outcome. The case-fatality rate was significantly higher among bacteremic infants compared with those without bacteremia (33% vs. 6%, p < .01). In the univariate model, sclerema (56% vs. 28%, p = .05), hyperglycemia (28% vs. 6%, p < .01), immature neutrophils [3.5 (00, 6.5) vs. 0.0 (0.0, 3.25); p = .02], higher C-reactive protein [2.7 (1.2, 7.4) vs. 1.8 (0.5, 4.2); p = .02], and lower serum total protein (51.1 +/- 14.1 vs. 57.6 +/- 12.2; p = .05) were identified as potential predictors of bacteremia. However, in the logistic regression analysis, after adjusting for confounders, only hypothermia (odds ratio = 6.4, 95% confidence Interval, 1.6-25.9; p = .01) and absent or uncountable peripheral pulse (odds ratio, 12.4, 95% confidence interval, 1.9-83.4; p < .01) remained significant independent predictors of bacteremia. CONCLUSIONS: Our data suggest that, in infants presenting with diarrhea and systemic inflammatory response syndrome, coexistence of hypothermia and absent or uncountable peripheral pulse is strongly associated with bacteremia. Bacteremia in this patient group is associated with high case-fatality rates.
Authors: Mohammod Jobayer Chisti; Chowdhury Ali Kawser; Abu Sayem Mirza Md Hasibur Rahman; Abu Sadat Mohammad Sayeem Bin Shahid; Farzana Afroze; K M Shahunja; Lubaba Shahrin; Monira Sarmin; Sharika Nuzhat; Ahmed Ehsanur Rahman; Tahmina Alam; Irin Parvin; M S T Mahmuda Ackhter; Gazi Md Salahuddin Mamun; Shamsun Nahar Shaima; Abu Syed Golam Faruque; Tahmeed Ahmed Journal: Sci Rep Date: 2022-06-24 Impact factor: 4.996
Authors: R Das; T Ahmed; H Saha; L Shahrin; F Afroze; A S M S B Shahid; K M Shahunja; P K Bardhan; M J Chisti Journal: Epidemiol Infect Date: 2016-12-28 Impact factor: 4.434
Authors: Mohammod J Chisti; Tahmeed Ahmed; Hasan Ashraf; A S G Faruque; Pradip K Bardhan; Sanjoy Kumer Dey; Sayeeda Huq; Sumon Kumar Das; Mohammed A Salam Journal: PLoS One Date: 2012-06-15 Impact factor: 3.240
Authors: Mohammod Jobayer Chisti; Mohammed Abdus Salam; Hasan Ashraf; Abu S G Faruque; Pradip Kumar Bardhan; Sumon Kumar Das; K M Shahunja; Abu S M S B Shahid; Tahmeed Ahmed Journal: PLoS One Date: 2013-08-12 Impact factor: 3.240
Authors: M J Chisti; M A Salam; T Ahmed; A S M S B Shahid; K M Shahunja; A S G Faruque; P K Bardhan; M I Hossain; M M Islam; S K Das; S Huq; L Shahrin; E Huq; F Chowdhury; H Ashraf Journal: Epidemiol Infect Date: 2014-06-03 Impact factor: 4.434
Authors: Mohammod Jobayer Chisti; Mohammed Abdus Salam; Hasan Ashraf; Abu S G Faruque; Pradip Kumar Bardhan; Md Iqbal Hossain; Abu S M S B Shahid; K M Shahunja; Sumon Kumar Das; Gazi Imran; Tahmeed Ahmed Journal: PLoS One Date: 2013-09-09 Impact factor: 3.240
Authors: Mohammod Jobayer Chisti; Stephen M Graham; Trevor Duke; Tahmeed Ahmed; Hasan Ashraf; Abu Syed Golam Faruque; Sophie La Vincente; Sayera Banu; Rubhana Raqib; Mohammed Abdus Salam Journal: PLoS One Date: 2014-04-02 Impact factor: 3.240