Coinfections and antimicrobial treatment in a cohort of falciparum malaria in a non-endemic country: a 10-year experience.
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 mala...
| Published in: | Infection Vol. 52; no. 2; pp. 461 - 470 |
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| Main Authors: | , , , , , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Apr2024
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176180888&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176180888 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Apr2024 vid: 52 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 176180888 173214416 176180888 176180888 10.1007/s15010-023-02103-x 176180888 ppf: 461 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Coinfections and antimicrobial treatment in a cohort of falciparum malaria in a non-endemic country: a 10-year experience. aug: au: Küpper-Tetzel, Claus P. Idris, Raja Kessel, Johanna Schüttfort, Gundolf Hoehl, Sebastian Kohmer, Niko Graf, Christiana Hogardt, Michael Besier, Silke Wichelhaus, Thomas A. Vehreschild, Maria J. G. T. Stephan, Christoph Wetzstein, Nils affil: Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany sug: subj: Malaria Epidemiology Coinfection Epidemiology Malaria Drug Therapy Coinfection Drug Therapy Antiinfective Agents Therapeutic Use Treatment Outcomes Human Germany Prospective Studies Multiple Logistic Regression Models, Statistical Prevalence Descriptive Statistics Comparative Studies Odds Ratio Confidence Intervals Antimicrobial Stewardship Public Health Disease Progression Communicable Diseases Risk Assessment ab: 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. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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