Bacterial Coinfection in Adults With Severe Malaria

作者：Ne Myo Aung, Phyo Pyae Nyein, Mar Mar Kyi, Josh Hanson · 发表于：Clinical Infectious Diseases · 年份：2020 · DOI：10.1093/cid/ciaa732 · 被引用次数：7 · 研究领域：Malaria Research and Control、Mosquito-borne diseases and control、Hemoglobinopathies and Related Disorders

To the Editor—Approximately 6.4% of children with severe malaria in malaria-endemic regions have concomitant bacteremia [1]. As coinfected children have a higher mortality and their bacterial infection may be difficult to diagnose, international guidelines recommend that they receive both antimalarial and empirical broad-spectrum antibacterial therapy [2]. The same guidelines state that adults with severe malaria should not receive empirical antibacterial therapy [2]. There have been few published data to support this recommendation and so the work by Phu et al—which identified concomitant bacteremia in only 9/845 (1.07%) Vietnamese adults with severe malaria—is very welcome [3]. However, their figure of 1.07% is likely an underestimate. For most of their 1991–2003 study, manual blood cultures were collected, which the authors acknowledge may have a lower sensitivity. From September 1997 they did use BACTEC-plus® bottles, but collected a suboptimal 5–8 mL of blood. They...