Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis
The Lancet Infectious Diseases·
- DOI
- 10.1016/s1473-3099(10)70072-4
- PMID
- 20510282
- PMCID
- PMC3168734
- OpenAlex
- W2090839261
- Study type
- Systematic review
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Community-acquired bloodstream infections in hospitalized African patients are common and carry high mortality. The findings suggest that strengthening clinical microbiology capacity and revising empirical treatment guidelines to reflect local bloodstream infection epidemiology may improve patient outcomes.
Structured evidence summary
Research question
The review sought to determine the prevalence and microbial causes of community-acquired bloodstream infections among hospitalized patients in Africa.
Study design
Systematic review and meta-analysis of prospective studies that enrolled hospitalized patients with at least one blood culture performed. The search covered three databases and identified 22 eligible studies.
Population and setting
The review included 58,296 patients admitted to hospitals in Africa, comprising 15,166 adults and 43,130 children.
Main findings
Bloodstream infections were detected in 13.5% of adults and 8.2% of children. Salmonella enterica was the most common non-malarial pathogen overall and in adults, accounting for 29.1% of non-malarial infections, with 58.4% being non-typhoidal strains. Streptococcus pneumoniae was the leading isolate in children, responsible for 18.3% of infections. Other notable pathogens included Staphylococcus aureus (9.5%) and Escherichia coli (7.3%). Mycobacterium tuberculosis complex represented 30.7% of isolates in studies employing mycobacterial culture. HIV infection was associated with increased risk of bloodstream infection, particularly those caused by Salmonella enterica and Mycobacterium tuberculosis complex. In-hospital case fatality among patients with bloodstream infections was 18.1%.
Public-health relevance
Community-acquired bloodstream infections in hospitalized African patients are common and carry high mortality. The findings suggest that strengthening clinical microbiology capacity and revising empirical treatment guidelines to reflect local bloodstream infection epidemiology may improve patient outcomes.
Important limitations
This summary relies on the supplied single-article abstract and bibliographic metadata. Full interpretation of study heterogeneity, quality assessment, methodological details, and context requires access to the complete manuscript.
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Evidence relationships
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