{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T08:54:39Z","timestamp":1784192079471,"version":"3.55.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"Supplement_5","license":[{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1159351"],"award-info":[{"award-number":["OPP1159351"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Christian Medical College Vellore Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Blood culture, despite low sensitivity, is the gold standard for enteric fever diagnosis. Understanding predictors of blood culture positivity may help design strategies to optimize enteric fever diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A cohort of 6760 children aged 0.5\u201315 years was followed for 3 years for enteric fever with blood cultures in an automated system, for fevers &amp;gt;3 days. Factors affecting test positivity in fevers and participant-level predictors for culture refusals were analyzed using regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 6097 suspected typhoid\/paratyphoid fever (STF) episodes were reported, of which 5703 (93.5%) STFs had sampling for blood cultures, with 394 (6.5%) refusals. Salmonella enterica serovar Typhi\/Paratyphi positivity was culture-confirmed in 3.8% (218\/5703) of STF episodes. Older children (odds ratio [OR], 1.96 [95% CI, 1.39\u20132.77]), larger blood volume inoculated (OR, 2.82 [95% CI, 1.71\u20134.66]), higher temperatures during fever (OR, 3.77 [95% CI, 2.89\u20134.91]), and fevers diagnosed as suspected typhoid or acute undifferentiated fever (OR, 6.06 [95% CI, 3.11\u201311.78]) had a higher probability of culture positivity. Antibiotics before culture did not decrease culture positivity. Blood culture refusals were higher for children from wealthier households or with milder illness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Performing blood cultures in older children with fever, especially those fevers with toxic presentation and increasing blood volume for inoculation are strategies to improve enteric fever detection in surveillance settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab357","type":"journal-article","created":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T11:08:40Z","timestamp":1625310520000},"page":"S484-S493","source":"Crossref","is-referenced-by-count":8,"title":["Factors Predicting Blood Culture Positivity in Children With Enteric Fever"],"prefix":"10.1093","volume":"224","author":[{"given":"Manikandan","family":"Srinivasan","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kulandaipalayam Natarajan","family":"Sindhu","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthikeyan","family":"Ramanujam","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjith Kumar","family":"Ramasamy","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathyapriya","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santhosh Kumar","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swathi","family":"Vajja","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita Shirley","family":"David","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Sciences, Wellcome Trust Research 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