Salmonella Bloodstream Infections in Hospitalized Children with Acute Febrile Illness—Uganda, 2016–2019

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dc.contributor.authorAppiah, Grace D.
dc.contributor.authorMpimbaza, Arthur
dc.contributor.authorLamorde, Mohammed
dc.contributor.authorFreeman, Molly
dc.contributor.authorKajumbula, Henry
dc.contributor.authorSalah, Zainab
dc.contributor.authorKugeler, Kiersten
dc.contributor.authorMikoleit, Matthew
dc.contributor.authorBumpus White, Porscha
dc.contributor.authorKapisi, James
dc.contributor.authorBorchert, Jeff
dc.contributor.authorSserwanga, Asadu
dc.contributor.authorVan Dyne, Susan
dc.contributor.authorMead, Paul
dc.contributor.authorKim, Sunkyung
dc.contributor.authorLauer, Ana C.
dc.contributor.authorWinstead, Alison
dc.contributor.authorManabe, Yukari C.
dc.contributor.authorFlick, Robert J.
dc.contributor.authorMintz, Eric
dc.date.accessioned2022-12-18T18:11:03Z
dc.date.available2022-12-18T18:11:03Z
dc.date.issued2021
dc.description.abstractInvasive Salmonella infection is a common cause of acute febrile illness (AFI) among children in sub- Saharan Africa; however, diagnosing Salmonella bacteremia is challenging in settings without blood culture. The Uganda AFI surveillance system includes blood culture-based surveillance for etiologies of bloodstream infection (BSIs) in hospitalized febrile children in Uganda. We analyzed demographic, clinical, blood culture, and antimicrobial resistance data from hospitalized children at six sentinel AFI sites from July 2016 to January 2019. A total of 47,261 children were hospitalized. Median age was 2 years (interquartile range, 1–4) and 26,695 (57%) were male. Of 7,203 blood cultures, 242 (3%) yielded bacterial pathogens including Salmonella (N = 67, 28%), Staphylococcus aureus (N = 40, 17%), Escherichia spp. (N = 25, 10%), Enterococcus spp. (N = 18, 7%), and Klebsiella pneumoniae (N = 17, 7%). Children with BSIs had longer median length of hospitalization (5 days versus 4 days), and a higher case-fatality ratio (13% versus 2%) than children without BSI (all P < 0.001). Children with Salmonella BSIs did not differ significantly in length of hospitalization or mortality from children with BSI resulting from other organisms. Serotype and antimicrobial susceptibility results were available for 49 Salmonella isolates, including 35 (71%) non-typhoidal serotypes and 14 Salmonella serotype Typhi (Typhi). Among Typhi isolates, 10 (71%) were multi-drug resistant and 13 (93%) had decreased ciprofloxacin susceptibility. Salmonella strains, particularly non-typhoidal serotypes and drug-resistant Typhi, were the most common cause of BSI. These data can inform regional Salmonella surveillance in East Africa and guide empiric therapy and prevention in Uganda.en_US
dc.identifier.citationAppiah, G. D., Mpimbaza, A., Lamorde, M., Freeman, M., Kajumbula, H., Salah, Z., ... & Mintz, E. (2021). Salmonella bloodstream infections in hospitalized children with acute febrile illness—Uganda, 2016–2019. The American Journal of Tropical Medicine and Hygiene, 105(1), 37. doi:10.4269/ajtmh.20-1453en_US
dc.identifier.other10.4269/ajtmh.20-1453
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/6423
dc.language.isoenen_US
dc.publisherThe American Journal of Tropical Medicine and Hygieneen_US
dc.subjectSalmonella Bloodstream Infectionsen_US
dc.subjectHospitalized Childrenen_US
dc.subjectFebrile Illnessen_US
dc.subjectUgandaen_US
dc.titleSalmonella Bloodstream Infections in Hospitalized Children with Acute Febrile Illness—Uganda, 2016–2019en_US
dc.typeArticleen_US
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