{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:00:04Z","timestamp":1785214804696,"version":"3.55.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0010414","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000}}],"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Community-acquired bacterial bloodstream infections are caused by diverse pathogens with changing antimicrobial-resistance patterns. In low-middle income countries in Southeast Asia, where dengue fever is endemic and a leading cause of fever, limited information is available about bacterial bloodstream infections due to challenges of implementing a blood culture service. This study describes bacterial bloodstream pathogens and antimicrobial-resistance patterns in Metro Manila, the Philippines. We aimed to identify the proportion of patients with a positive blood culture, the bacteria isolated and their antimicrobial resistance patterns, and the clinical characteristics of these patients, in this dengue endemic area. We conducted a prospective observational study in a single hospital enrolling febrile patients clinically suspected of having a community-acquired bacterial bloodstream infection between 1<jats:sup>st<\/jats:sup> July 2015 and 30<jats:sup>th<\/jats:sup> June 2019. Each patient had a blood culture and additional diagnostic tests according to their clinical presentation. We enrolled 1315 patients and a significant positive blood culture was found in 77 (5.9%) including <jats:italic>Staphylococcus aureus<\/jats:italic> (n = 20), <jats:italic>Salmonella enterica<\/jats:italic> Typhi (n = 18), <jats:italic>Escherichia coli<\/jats:italic> (n = 16), <jats:italic>Streptococcus pneumoniae<\/jats:italic> (n = 3) and <jats:italic>Burkholderia pseudomallei<\/jats:italic> (n = 2). Thirty-four patients had meningococcal disease diagnosed by culture (n = 8) or blood PCR (n = 26). Additional confirmed diagnoses included leptospirosis (n = 177), dengue virus infection (n = 159) and respiratory diphtheria (n = 50). There were 79 (6.0%, 95%CI 4.8%\u22127.4%) patients who died within 28 days of enrollment. Patients with a positive blood culture were significantly more likely to die than patients with negative culture (15.2% vs 4.4%, P&lt;0.01). Among <jats:italic>S<\/jats:italic>. <jats:italic>aureus<\/jats:italic> isolates, 11\/20 (55%) were methicillin-resistant (MRSA) and ST30: USA1100 was dominant sequence type (88.9%). Antimicrobial-susceptibility was well preserved in <jats:italic>S<\/jats:italic>. <jats:italic>enterica<\/jats:italic> Typhi. Among hospitalized patients with clinically suspected community-acquired bacterial bloodstream infection in Metro Manila, the Philippines, 5.9% had a blood culture confirmed infection of whom 15.6% died. <jats:italic>S<\/jats:italic>. <jats:italic>aureus<\/jats:italic>, including a significant number of MRSA (USA1100 clones), <jats:italic>S<\/jats:italic>. <jats:italic>enterica<\/jats:italic> Typhi, <jats:italic>E<\/jats:italic>.<jats:italic>coli<\/jats:italic> and <jats:italic>Neisseria meningitidis<\/jats:italic> were frequently identified pathogens.<\/jats:p>","DOI":"10.1371\/journal.pntd.0010414","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T17:44:04Z","timestamp":1653500644000},"page":"e0010414","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["A prospective observational study of community-acquired bacterial bloodstream infections in Metro Manila, the 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