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Volume 17, Number 10—October 2011

Dispatch

Bacteremia and Antimicrobial Drug Resistance over Time, Ghana

Uwe GroßComments to Author , Sylvarius K. Amuzu, Ring de Ciman, Iparkhan Kassimova, Lisa Groß, Wolfgang Rabsch, Ulrike Rosenberg, Marco Schulze, August Stich, and Ortrud Zimmermann
Author affiliations: University Medical Center, Göttingen, Germany (U. Groß, L. Groß, O. Zimmermann); Holy Family Hospital, Nkawkaw, Ghana (S.K. Amuzu); St. Francis Xavier Hospital, Assin Foso, Ghana (R. de Ciman); St. Martin de Porres Hospital, Eikwe, Ghana (I. Kassimova); Robert Koch Institute, Wernigerode, Germany (W. Rabsch); Helios Hospital, Northeim, Germany (U. Rosenberg); Medical Mission Institute, Würzburg, Germany (M. Schulze, A. Stich)

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Table 1

Comparative monitoring of bloodstream infections, Ghana, 2001–2002 and 2009*

Variable
July 2001–April 2002

July–September 2009
Total
Positive for Plasmodium spp.

Total
Positive for Plasmodium spp.
No. patients with fever of unknown origin 409 NA 258 NA
No. Plasmodium spp. positive/total no. tested (%)† 85/354 (24.0) NA 75/177 (42.4) NA
Total no. bacterial isolates 212 51 (24.1) 99 14 (14.1)
Skin flora contaminants 67 24 (35.8) 51 10 (19.6)
Potential pathogens
145 (100.0)
27 (18.6)

48 (100.0)
4 (8.3)
Salmonella enterica serovars 100 (69.0) 20 (20.0) 24 (50.0) 4 (16.7)
Typhi 59 (40.7) 11 (18.6) 15 (31.3) 2 (13.3)
Paratyphi 1 (0.7) NF 0 NF
Nontyphoid‡
40 (27.6)
9 (22.5)

9 (18.8)
2 (22.2)
Staphylococcus aureus 16 (11.0) 3 (18.8) 3 (6.3) NF
Enterobacteriaceae other than Salmonella spp. 10 (6.9) 1 (10.0) 8 (16.7) NF
Pseudomonas spp. 7 (4.8) 2 (28.6) 5 (10.4) NF
Other§ 12 (8.3) 1 (8.3) 8 (16.7) NF

*Values are no. (%) except as indicated. The total number of potential pathogens for each study period was set as 100%. Coagulase-negative staphylococci, microcooci, and bacilli were judged as skin flora contaminants. The ratio of Plasmodium spp.–positive patients in regard to bacterial species respective groups is indicated. NA, not applicable; NF, Plasmodium spp. not found.
†Blood film for Plasmodium spp. was done in most but not all cases. If the clinical situation, patient history, or blood count strongly indicated bacterial infection, blood culture was taken as first diagnostic approach.
S. enterica serovar Enteritidis and serovar Typhimurium.
§Including Streptococcus spp., Enterococcus spp., Acinetobacter spp.

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