Coinfections and antimicrobial treatment in a cohort of falciparum malaria in a non-endemic country : a 10-year experience
© 2023. The Author(s)..
INTRODUCTION: Falciparum malaria remains one of the deadliest infectious diseases worldwide. In Germany, it is mainly an imported infection among travellers. Rates of coinfection are often unknown, and a clinical rationale for the beneficial use of calculated antibiotic therapy in patients with malaria and suspected coinfection is lacking.
METHODS: We conducted an analysis of all in-patients treated with falciparum malaria at a German infectious diseases centre in vicinity to one of Europe's major airports for 2010-2019. Logistic regression and time-to-event analysis were used to evaluate predictors for bacterial coinfection, the use of antibacterial substances, as well as their influence on clinical course.
RESULTS: In total, 264 patients were included. Of those, 64% received an additional antibacterial therapy (n = 169). Twenty-nine patients (11.0%) were found to have suffered from a relevant bacterial coinfection, while only a small fraction had relevant bacteremia (n = 3, 1.4%). However, patients with severe malaria did not suffer from coinfections more frequently (p = 0.283). CRP levels were not a reliable predictor for a bacterial coinfection (OR 0.99, 95% CI 0.94-1.06, p = 0.850), while another clinical focus of infection was positively associated (OR 3.86, 95% CI 1.45-11.55, p = 0.010).
CONCLUSION: Although bacterial coinfections were rare in patients with malaria at our centre, the risk does not seem negligible. These data point rather towards individual risk assessment in respective patients than to general empiric antibiotic use.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:52 |
|---|---|
| Enthalten in: |
Infection - 52(2024), 2 vom: 10. März, Seite 461-469 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Küpper-Tetzel, Claus P [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Bacterial Agents |
|---|
| Anmerkungen: |
Date Completed 21.03.2024 Date Revised 23.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s15010-023-02103-x |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM363814418 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM363814418 | ||
| 003 | DE-627 | ||
| 005 | 20240323234725.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s15010-023-02103-x |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1342.xml |
| 035 | |a (DE-627)NLM363814418 | ||
| 035 | |a (NLM)37889376 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Küpper-Tetzel, Claus P |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Coinfections and antimicrobial treatment in a cohort of falciparum malaria in a non-endemic country |b a 10-year experience |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 21.03.2024 | ||
| 500 | |a Date Revised 23.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a INTRODUCTION: Falciparum malaria remains one of the deadliest infectious diseases worldwide. In Germany, it is mainly an imported infection among travellers. Rates of coinfection are often unknown, and a clinical rationale for the beneficial use of calculated antibiotic therapy in patients with malaria and suspected coinfection is lacking | ||
| 520 | |a METHODS: We conducted an analysis of all in-patients treated with falciparum malaria at a German infectious diseases centre in vicinity to one of Europe's major airports for 2010-2019. Logistic regression and time-to-event analysis were used to evaluate predictors for bacterial coinfection, the use of antibacterial substances, as well as their influence on clinical course | ||
| 520 | |a RESULTS: In total, 264 patients were included. Of those, 64% received an additional antibacterial therapy (n = 169). Twenty-nine patients (11.0%) were found to have suffered from a relevant bacterial coinfection, while only a small fraction had relevant bacteremia (n = 3, 1.4%). However, patients with severe malaria did not suffer from coinfections more frequently (p = 0.283). CRP levels were not a reliable predictor for a bacterial coinfection (OR 0.99, 95% CI 0.94-1.06, p = 0.850), while another clinical focus of infection was positively associated (OR 3.86, 95% CI 1.45-11.55, p = 0.010) | ||
| 520 | |a CONCLUSION: Although bacterial coinfections were rare in patients with malaria at our centre, the risk does not seem negligible. These data point rather towards individual risk assessment in respective patients than to general empiric antibiotic use | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Plasmodium falciparum | |
| 650 | 4 | |a Antibiotic stewardship | |
| 650 | 4 | |a Falciparum malaria | |
| 650 | 4 | |a Malaria | |
| 650 | 4 | |a Returning travellers | |
| 650 | 4 | |a Visiting friends and relatives | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 650 | 7 | |a Antimalarials |2 NLM | |
| 700 | 1 | |a Idris, Raja |e verfasserin |4 aut | |
| 700 | 1 | |a Kessel, Johanna |e verfasserin |4 aut | |
| 700 | 1 | |a Schüttfort, Gundolf |e verfasserin |4 aut | |
| 700 | 1 | |a Hoehl, Sebastian |e verfasserin |4 aut | |
| 700 | 1 | |a Kohmer, Niko |e verfasserin |4 aut | |
| 700 | 1 | |a Graf, Christiana |e verfasserin |4 aut | |
| 700 | 1 | |a Hogardt, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Besier, Silke |e verfasserin |4 aut | |
| 700 | 1 | |a Wichelhaus, Thomas A |e verfasserin |4 aut | |
| 700 | 1 | |a Vehreschild, Maria J G T |e verfasserin |4 aut | |
| 700 | 1 | |a Stephan, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Wetzstein, Nils |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Infection |d 1973 |g 52(2024), 2 vom: 10. März, Seite 461-469 |w (DE-627)NLM00001740X |x 1439-0973 |7 nnns |
| 773 | 1 | 8 | |g volume:52 |g year:2024 |g number:2 |g day:10 |g month:03 |g pages:461-469 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s15010-023-02103-x |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 52 |j 2024 |e 2 |b 10 |c 03 |h 461-469 | ||