{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:28:29Z","timestamp":1787020109815,"version":"build-2736575974"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The rise of Multidrug-resistant organisms (MDROs) poses a considerable burden on the healthcare systems, particularly in low-middle income countries like Pakistan. There is a scarcity of data on the carriage of MDRO particularly in the pediatrics population therefore, we aimed to determine MDRO carriage in pediatric patients at the time of admission to a tertiary care hospital in Karachi, Pakistan, and to identify the risk factors associated with it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study conducted at the pediatric department of Aga Khan University Hospital (AKUH) from May to September 2019 on 347 children aged 1\u201318\u2009years. For identification of MDRO (i.e.,\n                      <jats:italic>Extended Spectrum Beta-Lactamase<\/jats:italic>\n                      (ESBL) producers,\n                      <jats:italic>Carbapenem Resistant Enterobacteriaceae<\/jats:italic>\n                      (CRE),\n                      <jats:italic>Vancomycin Resistant Enterococci<\/jats:italic>\n                      (VRE), M\n                      <jats:italic>ethicillin Resistant Staphylococcus aureus<\/jats:italic>\n                      (MRSA), Multidrug-resistant (MDR)\n                      <jats:italic>Acinetobacter species<\/jats:italic>\n                      and\n                      <jats:italic>MDR Pseudomonas aeruginosa<\/jats:italic>\n                      ), nasal swabs and rectal swabs or stool samples were cultured on specific media within 72\u2009h of hospitalization. Data was collected on a predesigned structured questionnaire on demographics, prior use of antibiotics for &gt;\u200948\u2009h in the last 6\u2009months, history of vaccination in last 6\u2009months, exposure to health care facility regardless of the time of exposure, ICU stay for &gt;\u200972\u2009h, and about the prior use of medical devices (urinary catheter, central venous lines etc.) in last 1 year. Statistical analysis was performed by Standard statistical software.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 347 participants, 237 (68.3%) were found to be MDRO carriers. Forty nine nasal swabs from 346 children (14.2%) showed growth of MRSA. The majority of the stool\/rectal swabs (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u2009222 of 322; 69%) collected were positive for MDRO. The most isolated species were ESBL\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      174\/222 (78.3%) followed by ESBL\n                      <jats:italic>Enterobacter species<\/jats:italic>\n                      37\/222 (16.7%) and ESBL\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      35\/222 (15.8%). On univariate analysis, none of the risk factors showed statistically significant association with MDRO carriage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall, a high prevalence of MDRO carriage was identified among admitted pediatric patients. Implementation of systematic screening may help to identify true burden of MDROs carriage in the health care settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-021-06275-5","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T13:11:12Z","timestamp":1623244272000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Prevalence and risk factors associated with multi-drug resistant organisms (MDRO) carriage among pediatric patients at the time of admission in a tertiary care hospital of a developing country. A cross-sectional study"],"prefix":"10.1186","volume":"21","author":[{"given":"Sonia","family":"Qureshi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noshi","family":"Maria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Zeeshan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Irfan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Naz","family":"Qamar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"issue":"4","key":"6275_CR1","doi-asserted-by":"publisher","first-page":"e51","DOI":"10.1016\/S1473-3099(20)30003-7","volume":"20","author":"R Laxminarayan","year":"2020","unstructured":"Laxminarayan R, Van Boeckel T, Frost I, Kariuki S, Khan EA, Limmathurotsakul D, et al. The lancet infectious diseases commission on antimicrobial resistance: 6 years later. Lancet Infect Dis. 2020;20(4):e51\u201360. https:\/\/doi.org\/10.1016\/S1473-3099(20)30003-7.","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"6275_CR2","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","volume":"18","author":"AP Magiorakos","year":"2012","unstructured":"Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268\u201381. https:\/\/doi.org\/10.1111\/j.1469-0691.2011.03570.x.","journal-title":"Clin Microbiol Infect"},{"issue":"5","key":"6275_CR3","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1093\/cid\/cir899","volume":"54","author":"PK Tosh","year":"2012","unstructured":"Tosh PK, McDonald LC. Infection control in the multidrug-resistant era: tending the human microbiome. Clin Infect Dis. 2012;54(5):707\u201313. https:\/\/doi.org\/10.1093\/cid\/cir899.","journal-title":"Clin Infect Dis"},{"issue":"5","key":"6275_CR4","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1056\/NEJMp0804651","volume":"360","author":"CA Arias","year":"2009","unstructured":"Arias CA, Murray BE. Antibiotic-resistant bugs in the 21st century--a clinical super-challenge. N Engl J Med. 2009;360(5):439\u201343. https:\/\/doi.org\/10.1056\/NEJMp0804651.","journal-title":"N Engl J Med"},{"issue":"5","key":"6275_CR5","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1089\/sur.2010.076","volume":"12","author":"LH Rosenberger","year":"2011","unstructured":"Rosenberger LH, Hranjec T, Politano AD, Swenson BR, Metzger R, Bonatti H, et al. Effective cohorting and \"superisolation\" in a single intensive care unit in response to an outbreak of diverse multi-drug-resistant organisms. Surg Infect. 2011;12(5):345\u201350. https:\/\/doi.org\/10.1089\/sur.2010.076.","journal-title":"Surg Infect"},{"issue":"1","key":"6275_CR6","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1186\/1472-6963-12-122","volume":"12","author":"E Morales","year":"2012","unstructured":"Morales E, Cots F, Sala M, Comas M, Belvis F, Riu M, et al. Hospital costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. BMC Health Serv Res. 2012;12(1):122. https:\/\/doi.org\/10.1186\/1472-6963-12-122.","journal-title":"BMC Health Serv Res"},{"issue":"6","key":"6275_CR7","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1007\/s12519-019-00276-w","volume":"15","author":"D Yusef","year":"2019","unstructured":"Yusef D, Jahmani T, Kailani S, Al-Rawi R, Khasawneh W, Almomani M. Community-acquired serious bacterial infections in the first 90 days of life: a revisit in the era of multi-drug-resistant organisms. World J Pediatr. 2019;15(6):580\u20135. https:\/\/doi.org\/10.1007\/s12519-019-00276-w.","journal-title":"World J Pediatr"},{"issue":"11","key":"6275_CR8","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.1017\/ice.2016.185","volume":"37","author":"L Folgori","year":"2016","unstructured":"Folgori L, Bernaschi P, Piga S, Carletti M, Cunha FP, Lara PH, et al. Healthcare-associated infections in pediatric and neonatal intensive care units: impact of underlying risk factors and antimicrobial resistance on 30-day case-fatality in Italy and Brazil. Infect Control Hosp Epidemiol. 2016;37(11):1302\u20139. https:\/\/doi.org\/10.1017\/ice.2016.185.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"11","key":"6275_CR9","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1086\/591861","volume":"29","author":"AI Hidron","year":"2008","unstructured":"Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA, et al. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol. 2008;29(11):996\u20131011. https:\/\/doi.org\/10.1086\/591861.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"4","key":"6275_CR10","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1093\/jpids\/piw064","volume":"6","author":"LK Logan","year":"2017","unstructured":"Logan LK, Gandra S, Mandal S, Klein EY, Levinson J, Weinstein RA, et al. Multidrug- and Carbapenem-resistant Pseudomonas aeruginosa in children, United States, 1999-2012. J Pediatric Infect Dis Soc. 2017;6(4):352\u20139. https:\/\/doi.org\/10.1093\/jpids\/piw064.","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"11","key":"6275_CR11","doi-asserted-by":"publisher","first-page":"2014","DOI":"10.3201\/eid2111.150548","volume":"21","author":"LK Logan","year":"2015","unstructured":"Logan LK, Renschler JP, Gandra S, Weinstein RA, Laxminarayan R, Centers for disease C, et al. Carbapenem-resistant Enterobacteriaceae in children, United States, 1999-2012. Emerg Infect Dis. 2015;21(11):2014\u201321. https:\/\/doi.org\/10.3201\/eid2111.150548.","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"6275_CR12","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1093\/jpids\/piw093","volume":"7","author":"SB Meropol","year":"2018","unstructured":"Meropol SB, Haupt AA, Debanne SM. Incidence and outcomes of infections caused by multidrug-resistant Enterobacteriaceae in children, 2007-2015. J Pediatric Infect Dis Soc. 2018;7(1):36\u201345. https:\/\/doi.org\/10.1093\/jpids\/piw093.","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"1","key":"6275_CR13","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s13054-017-1646-9","volume":"21","author":"AG DePorre","year":"2017","unstructured":"DePorre AG, Aronson PL, McCulloh RJ. Facing the ongoing challenge of the febrile young infant. Crit Care. 2017;21(1):68. https:\/\/doi.org\/10.1186\/s13054-017-1646-9.","journal-title":"Crit Care"},{"issue":"1","key":"6275_CR14","doi-asserted-by":"publisher","first-page":"1419047","DOI":"10.1080\/19932820.2017.1419047","volume":"13","author":"M Tfifha","year":"2018","unstructured":"Tfifha M, Ferjani A, Mallouli M, Mlika N, Abroug S, Boukadida J. Carriage of multidrug-resistant bacteria among pediatric patients before and during their hospitalization in a tertiary pediatric unit in Tunisia. Libyan J Med. 2018;13(1):1419047. https:\/\/doi.org\/10.1080\/19932820.2017.1419047.","journal-title":"Libyan J Med"},{"issue":"5","key":"6275_CR15","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1017\/ice.2016.16","volume":"37","author":"N Suwantarat","year":"2016","unstructured":"Suwantarat N, Logan LK, Carroll KC, Bonomo RA, Simner PJ, Rudin SD, et al. The prevalence and molecular epidemiology of multidrug-resistant Enterobacteriaceae colonization in a pediatric intensive care unit. Infect Control Hosp Epidemiol. 2016;37(5):535\u201343. https:\/\/doi.org\/10.1017\/ice.2016.16.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"3","key":"6275_CR16","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.jiph.2014.11.002","volume":"8","author":"R Thummeepak","year":"2015","unstructured":"Thummeepak R, Leerach N, Kunthalert D, Tangchaisuriya U, Thanwisai A, Sitthisak S. High prevalence of multi-drug resistant Streptococcus pneumoniae among healthy children in Thailand. J Infect Public Health. 2015;8(3):274\u201381. https:\/\/doi.org\/10.1016\/j.jiph.2014.11.002.","journal-title":"J Infect Public Health"},{"issue":"5","key":"6275_CR17","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1086\/502217","volume":"24","author":"L Saiman","year":"2003","unstructured":"Saiman L, Cronquist A, Wu F, Zhou J, Rubenstein D, Eisner W, et al. An outbreak of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Infect Control Hosp Epidemiol. 2003;24(5):317\u201321. https:\/\/doi.org\/10.1086\/502217.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"1","key":"6275_CR18","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1017\/ice.2014.4","volume":"36","author":"CS Lee","year":"2015","unstructured":"Lee CS, Montalmont B, O'Hara JA, Syed A, Chaussard C, McGaha TL, et al. Screening for methicillin-resistant Staphylococcus aureus colonization using sponges. Infect Control Hosp Epidemiol. 2015;36(1):28\u201333. https:\/\/doi.org\/10.1017\/ice.2014.4.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"3_Suppl","key":"6275_CR19","doi-asserted-by":"publisher","first-page":"48","DOI":"10.4269\/ajtmh.18-0145","volume":"99","author":"JK Das","year":"2018","unstructured":"Das JK, Hasan R, Zafar A, Ahmed I, Ikram A, Nizamuddin S, et al. Trends, associations, and antimicrobial resistance of salmonella Typhi and Paratyphi in Pakistan. Am J Trop Med Hyg. 2018;99(3_Suppl):48\u201354.","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"6275_CR20","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1186\/s12879-016-1673-1","volume":"16","author":"K Jabeen","year":"2016","unstructured":"Jabeen K, Bhawan Mal P, Khan E, Chandio S, Jacobsson S, Unemo M. Antimicrobial resistance and Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) genotypes in N. gonorrhoeae during 2012-2014 in Karachi, Pakistan. BMC Infect Dis. 2016;16(1):353. https:\/\/doi.org\/10.1186\/s12879-016-1673-1.","journal-title":"BMC Infect Dis"},{"issue":"3","key":"6275_CR21","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1093\/heapol\/czz022","volume":"34","author":"MS Khan","year":"2019","unstructured":"Khan MS, Durrance-Bagale A, Legido-Quigley H, Mateus A, Hasan R, Spencer J, et al. 'LMICs as reservoirs of AMR': a comparative analysis of policy discourse on antimicrobial resistance with reference to Pakistan. Health Policy Plan. 2019;34(3):178\u201387. https:\/\/doi.org\/10.1093\/heapol\/czz022.","journal-title":"Health Policy Plan"},{"issue":"6","key":"6275_CR22","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.jiph.2013.06.006","volume":"6","author":"F Nahid","year":"2013","unstructured":"Nahid F, Khan AA, Rehman S, Zahra R. Prevalence of metallo-beta-lactamase NDM-1-producing multi-drug resistant bacteria at two Pakistani hospitals and implications for public health. J Infect Public Health. 2013;6(6):487\u201393. https:\/\/doi.org\/10.1016\/j.jiph.2013.06.006.","journal-title":"J Infect Public Health"},{"issue":"5","key":"6275_CR23","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.12669\/pjms.295.3695","volume":"29","author":"S Begum","year":"2013","unstructured":"Begum S, Hasan F, Hussain S, Ali SA. Prevalence of multi drug resistant Acinetobacter baumannii in the clinical samples from tertiary Care Hospital in Islamabad. Pakistan Pak J Med Sci. 2013;29(5):1253\u20138. https:\/\/doi.org\/10.12669\/pjms.295.3695.","journal-title":"Pakistan Pak J Med Sci"},{"key":"6275_CR24","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1186\/s12879-015-1105-7","volume":"15","author":"X Ma","year":"2015","unstructured":"Ma X, Wu Y, Li L, Xu Q, Hu B, Ni Y, et al. First multicenter study on multidrug resistant bacteria carriage in Chinese ICUs. BMC Infect Dis. 2015;15:358.","journal-title":"BMC Infect Dis"},{"issue":"12","key":"6275_CR25","doi-asserted-by":"publisher","first-page":"e51981","DOI":"10.1371\/journal.pone.0051981","volume":"7","author":"J Isendahl","year":"2012","unstructured":"Isendahl J, Turlej-Rogacka A, Manjuba C, Rodrigues A, Giske CG, Naucler P. Fecal carriage of ESBL-producing E. coli and K. pneumoniae in children in Guinea-Bissau: a hospital-based cross-sectional study. PLoS One. 2012;7(12):e51981.","journal-title":"PLoS One"},{"issue":"1","key":"6275_CR26","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1186\/1471-2334-10-204","volume":"10","author":"T Andriatahina","year":"2010","unstructured":"Andriatahina T, Randrianirina F, Hariniana ER, Talarmin A, Raobijaona H, Buisson Y, et al. High prevalence of fecal carriage of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a pediatric unit in Madagascar. BMC Infect Dis. 2010;10(1):204. https:\/\/doi.org\/10.1186\/1471-2334-10-204.","journal-title":"BMC Infect Dis"},{"issue":"9","key":"6275_CR27","doi-asserted-by":"publisher","first-page":"947","DOI":"10.3855\/jidc.7593","volume":"10","author":"SM Hijazi","year":"2016","unstructured":"Hijazi SM, Fawzi MA, Ali FM, Abd El Galil KH. Multidrug-resistant ESBL-producing Enterobacteriaceae and associated risk factors in community infants in Lebanon. J Infect Dev Ctries. 2016;10(9):947\u201355. https:\/\/doi.org\/10.3855\/jidc.7593.","journal-title":"J Infect Dev Ctries"},{"issue":"8","key":"6275_CR28","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1089\/mdr.2018.0318","volume":"25","author":"A Kiddee","year":"2019","unstructured":"Kiddee A, Assawatheptawee K, Na-Udom A, Boonsawang P, Treebupachatsakul P, Walsh TR, et al. Risk factors for extended-Spectrum beta-lactamase-producing Enterobacteriaceae carriage in patients admitted to intensive care unit in a tertiary Care Hospital in Thailand. Microb Drug Resist. 2019;25(8):1182\u201390. https:\/\/doi.org\/10.1089\/mdr.2018.0318.","journal-title":"Microb Drug Resist"},{"issue":"10","key":"6275_CR29","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1017\/ice.2019.215","volume":"40","author":"MT Murray","year":"2019","unstructured":"Murray MT, Beauchemin MP, Neu N, Larson EL. Prior antibiotic use and acquisition of multidrug-resistant organisms in hospitalized children: a systematic review. Infect Control Hosp Epidemiol. 2019;40(10):1107\u201315. https:\/\/doi.org\/10.1017\/ice.2019.215.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"11","key":"6275_CR30","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1086\/522678","volume":"28","author":"C Buke","year":"2007","unstructured":"Buke C, Armand-Lefevre L, Lolom I, Guerinot W, Deblangy C, Ruimy R, et al. Epidemiology of multidrug-resistant bacteria in patients with long hospital stays. Infect Control Hosp Epidemiol. 2007;28(11):1255\u201360. https:\/\/doi.org\/10.1086\/522678.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"4","key":"6275_CR31","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1542\/peds.108.4.856","volume":"108","author":"MH Samore","year":"2001","unstructured":"Samore MH, Magill MK, Alder SC, Severina E, Morrison-De Boer L, Lyon JL, et al. High rates of multiple antibiotic resistance in Streptococcus pneumoniae from healthy children living in isolated rural communities: association with cephalosporin use and intrafamilial transmission. Pediatrics. 2001;108(4):856\u201365. https:\/\/doi.org\/10.1542\/peds.108.4.856.","journal-title":"Pediatrics."},{"issue":"1","key":"6275_CR32","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.ajic.2013.07.008","volume":"42","author":"M Tarchouna","year":"2014","unstructured":"Tarchouna M, Ferjani A, Tilouche S, Marzouk M, Bouguila J, Boughamoura L, et al. Screening at admission for carrier prevalence of multidrug-resistant organisms in a pediatric unit. Am J Infect Control. 2014;42(1):88\u20139. https:\/\/doi.org\/10.1016\/j.ajic.2013.07.008.","journal-title":"Am J Infect Control"},{"issue":"3","key":"6275_CR33","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.gheart.2014.08.009","volume":"9","author":"LM Bebell","year":"2014","unstructured":"Bebell LM, Muiru AN. Antibiotic use and emerging resistance: how can resource-limited countries turn the tide? Glob Heart. 2014;9(3):347\u201358. https:\/\/doi.org\/10.1016\/j.gheart.2014.08.009.","journal-title":"Glob Heart"},{"issue":"4(Suppl.)","key":"6275_CR34","first-page":"1483","volume":"30","author":"MT Baig","year":"2017","unstructured":"Baig MT, Sial AA, Huma A, Ahmed M, Shahid U, Syed N. Irrational antibiotic prescribing practice among children in critical care of tertiary hospitals. Pak J Pharm Sci. 2017;30(4(Suppl.)):1483\u20139.","journal-title":"Pak J Pharm Sci"},{"issue":"10218","key":"6275_CR35","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/S0140-6736(19)32999-X","volume":"395","author":"M Ali","year":"2020","unstructured":"Ali M, Abbasi BH, Ahmad N, Fazal H, Khan J, Ali SS. Over-the-counter medicines in Pakistan: misuse and overuse. Lancet. 2020;395(10218):116. https:\/\/doi.org\/10.1016\/S0140-6736(19)32999-X.","journal-title":"Lancet."},{"issue":"1","key":"6275_CR36","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1186\/s13756-019-0649-5","volume":"8","author":"Z Saleem","year":"2019","unstructured":"Saleem Z, Saeed H, Hassali MA, Godman B, Asif U, Yousaf M, et al. Pattern of inappropriate antibiotic use among hospitalized patients in Pakistan: a longitudinal surveillance and implications. Antimicrob Resist Infect Control. 2019;8(1):188. https:\/\/doi.org\/10.1186\/s13756-019-0649-5.","journal-title":"Antimicrob Resist Infect Control"},{"key":"6275_CR37","doi-asserted-by":"crossref","unstructured":"Hayat K, Rosenthal M, Gillani AH, Zhai P, Aziz MM, Ji W, et al. Perspective of Pakistani physicians towards hospital antimicrobial stewardship programs: a multisite exploratory qualitative study. Int J Environ Res Public Health. 2019;16(9):1565.","DOI":"10.3390\/ijerph16091565"},{"key":"6275_CR38","unstructured":"WHO Global Code of Practice on International Recruitment of Health Personnel. 2011."}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06275-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06275-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06275-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T13:11:24Z","timestamp":1623244284000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06275-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,9]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6275"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06275-5","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,9]]},"assertion":[{"value":"3 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethical Review Committee (ERC) of Aga Khan University Hospital Karachi (ERC No: 2019\u20130653-2209). Data was collected from enrolled participants after informed consent from parents or guardians of patients aged 1\u201318\u2009years.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No competing interests to be declared by authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"547"}}