{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T14:19:47Z","timestamp":1781705987755,"version":"3.54.5"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,7,27]],"date-time":"2019-07-27T00:00:00Z","timestamp":1564185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Seventh Framework programme","award":["279185"],"award-info":[{"award-number":["279185"]}]},{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["206508\/Z\/17\/Z"],"award-info":[{"award-number":["206508\/Z\/17\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The limited availability of microbiology services in sub-Saharan Africa impedes accurate diagnosis of bacterial pathogens and understanding of trends in prevalence and antibiotic sensitivities. We aimed to characterize bacteremia among hospitalized children in The Gambia and to identify factors associated with bacteremia and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We prospectively studied children presenting with suspected severe infection to 2 urban hospitals in The Gambia, between January 2013 and September 2015. Demographic and anthropometric data, clinical features, management, and blood culture results were documented. Urine screens for antibiotic activity were performed in a subset of participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 411 children enrolled (median age, 29 months; interquartile range, 11\u201382), 79.5% (325 of 409) reported prehospital antibiotic use. Antimicrobial activity by urinary screen for antibiotic activity was detected in 70.8% (n = 80 of 113). Sixty-six bacterial pathogens were identified in 65 (15.8%) participants and Staphylococcus aureus predominated. Gram-positive organisms were more commonly identified than Gram-negative (P &amp;lt; .01). Antibiotic resistance against first-line antimicrobials (ampicillin and gentamicin) was common among Gram-negative bacteria (39%; range, 25%\u2013100%). Factors significantly associated with bacteremia included the following: gender, hydration status, musculoskeletal examination findings, admission to the Medical Research Council The Gambia at London School of Hygiene &amp; Tropical Medicine hospital, and meeting sepsis criteria. Those associated with increased mortality were presence of a comorbidity, clinical pallor, tachypnea, and altered consciousness. Tachycardia was associated with reduced mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The bacteremia rate in children with suspected childhood life-threatening infectious diseases in The Gambia is high. The pattern of pathogen prevalence and antimicrobial resistance has changed over time compared with previous studies illustrating the importance of robust bacterial surveillance programs in resource-limited settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofz332","type":"journal-article","created":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T18:47:23Z","timestamp":1565203643000},"source":"Crossref","is-referenced-by-count":14,"title":["Bacteremia in Childhood Life-Threatening Infections in Urban Gambia: EUCLIDS in West Africa"],"prefix":"10.1093","volume":"6","author":[{"given":"F","family":"Secka","sequence":"first","affiliation":[{"name":"Medical Research Council The Gambia at London School of Hygiene & Tropical Medicine, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6941-6491","authenticated-orcid":false,"given":"J 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United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S M A","family":"Zaman","sequence":"additional","affiliation":[{"name":"Medical Research Council The Gambia at London School of Hygiene & Tropical Medicine, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Cebey-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria de Santiago, Genetics-Vaccines-Infectious Diseases and Paediatrics Research Group, GENVIP, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N P","family":"Boeddha","sequence":"additional","affiliation":[{"name":"Erasmus MC-Sophia Children\u2019s Hospital, University Medical Center Rotterdam, Intensive Care and Department of Paediatric Surgery, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Paulus","sequence":"additional","affiliation":[{"name":"University of Liverpool Institute of Infection and Global Health, Department of Clinical Infection Microbiology and Immunology, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D S","family":"Kohlf\u00fcrst","sequence":"additional","affiliation":[{"name":"Medical University of Graz, Department of General Paediatrics, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Emonts","sequence":"additional","affiliation":[{"name":"Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom"},{"name":"Paediatric Infectious Diseases and Immunology Department, Newcastle upon Tyne Hospitals Foundation Trust, Great North Children\u2019s Hospital, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Zenz","sequence":"additional","affiliation":[{"name":"Medical University of Graz, Department of General Paediatrics, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E D","family":"Carrol","sequence":"additional","affiliation":[{"name":"University of Liverpool Institute of Infection and Global Health, Department of Clinical Infection Microbiology and Immunology, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"de Groot","sequence":"additional","affiliation":[{"name":"Paediatric Infectious Diseases and Immunology, Amalia Children\u2019s Hospital, and Expertise Center for Immunodeficiency and Autoinflammation, and Section Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, and Radboud Center for Infectious Diseases, Radboudumc, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Schlapbach","sequence":"additional","affiliation":[{"name":"University Children\u2019s Hospital Zurich and the Children\u2019s Research Center, 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