Baseline characteristics of study patients are shown Cabozantinib prostate in Table Table1.1. In total, 216 (74%) children had a serious bacterial infection (SBI), and 77 had no organism identified (NBI). Of the 216 children with SBI, 182 (62%) had a gram-positive organism, 33 (11%) had a gram-negative organism, and one child had both gram-positive and -negative infections. The etiologies of both pneumonia and meningitis are shown in Table Table22.Table 1Demographic, clinical, and laboratory characteristics of study patients by disease presentationTable 2Etiology of pneumonia and meningitisPlasma VEGF, PDGF, and FGF in children with severe bacterial infectionPlasma VEGF, PDGF, and FGF on admission were significantly elevated in children with severe bacterial infection compared with healthy controls (Table (Table3).

3). No significant difference in plasma growth factors was found between children with bacterial meningitis and those with pneumonia or between HIV-infected and HIV-uninfected children. The mean plasma VEGF concentrations were significantly higher in children with SBI compared with those with NBI, and plasma concentrations of all three growth factors were significantly higher in patients with gram-positive than in those with gram-negative infections (Table (Table3).3). Mean plasma PDGF concentrations were significantly higher in survivors compared with nonsurvivors. VEGF, PDGF, and FGF concentrations were significantly higher in children with invasive pneumococcal disease compared with children with SBI caused by pathogens other than S. pneumoniae (Table (Table3).3).

PDGF concentrations were lower in children who had received antibiotics before hospital admission (P = 0.02). No significant differences were noted in mean VEGF, PDGF, and FGF concentrations in children with wasting or stunting and those without, and no correlation occurred with duration of symptoms (data not shown).Table 3Summary of growth factors in Malawian children with sepsisCSF VEGF, PDGF, and FGF in children with bacterial meningitisIn 50 children with bacterial meningitis, CSF VEGF, PDGF, and FGF were measured. CSF concentrations of VEGF, PDGF, and FGF were significantly higher than paired plasma concentrations (P = 0.001; P < 0.005; and P < 0.0005, respectively, Wilcoxon signed rank test). No significant correlations appeared between the CSF concentrations of VEGF, PDGF, or FGF and the CSF white cell count, CSF absolute neutrophil count, or Blantyre coma score.

In children with pneumococcal meningitis (n = 30), significant correlations were noted between CSF pneumococcal bacterial load and the concentration of VEGF and Brefeldin_A FGF in the CSF (Figure (Figure1),1), and the CSF concentrations of both of these growth factors were higher in patients who died than in those who survived.Figure 1Scatterplot showing CSF VEGF and FGF against CSF pneumococcal bacterial load in children with pneumococcal meningitis.