CAUSES OF COMMUNITY-ACQUIRED BACTEREMIA AND PATTERNS OF ANTIMICROBIAL RESISTANCE IN VIENTIANE, LAOS

RATTANAPHONE PHETSOUVANH Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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SIMMALY PHONGMANY Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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DOUANGDAO SOUKALOUN Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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BOUACHANH RASACHAK Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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VIMONE SOUKHASEUM Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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SEUN SOUKHASEUM Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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KAMTHAVI FRICHITHAVONG Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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SENGMANIVONG KHOUNNORATH Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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BOUNTHOM PENGDEE Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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KHAMPHONG PHIASAKHA Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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VANG CHU Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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KHONESAVANH LUANGXAY Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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SAYADETH RATTANAVONG Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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KONKAM SISOUK Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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VALY KEOLOUANGKOT Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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MAYFONG MAYXAY Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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ANDREW RAMSAY Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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STUART D. BLACKSELL Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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JIM CAMPBELL Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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BERTRAND MARTINEZ-AUSSEL Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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MAYBOUN HEUANVONGSY Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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BOUNTHAPAANY BOUNXOUEI Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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CHANPHENG THAMMAVONG Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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BOUNKONG SYHAVONG Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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MICHEL STROBEL Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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SHARON J. PEACOCK Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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NICHOLAS J. WHITE Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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PAUL N. NEWTON Wellcome Trust- Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR; Francophone Institute of Tropical Medicine, Vientiane, Lao PDR; Faculty of Medicine, National University of Laos, Vientiane, Lao PDR; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Oxford University Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam

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There is no published information on the causes of bacteremia in the Lao PDR (Laos). Between 2000 and 2004, 4512 blood culture pairs were taken from patients admitted to Mahosot Hospital, Vientiane, Laos, with suspected community-acquired bacteremia; 483 (10.7%) cultures grew a clinically significant community-acquired organism, most commonly Salmonella enterica serovar typhi (50.9%), Staphylococcus aureus (19.0%), and Escherichia coli (12.4%). S. aureus bacteremia was common among infants (69.2%), while children 1–5 years had a high frequency of typhoid (44%). Multi–drug-resistant S. Typhi was rare (6%). On multiple logistic regression analysis, typhoid was associated with younger age, longer illness, diarrhea, higher admission temperature, and lower peripheral white blood cell count than non-typhoidal bacteremia. Empirical parenteral ampicillin and gentamicin would have some activity against ~ 88% of clinically significant isolates at a cost of US $1.4/day, an important exception being B. pseudomallei. Bacteremic infants in this setting require an anti-staphylococcal antibiotic.

Author Notes

Reprint requests: Paul N. Newton, Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR, Telephone and fax: (856) 21 242168, E-mail: paul@tropmedres.ac.
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