{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:31:17Z","timestamp":1786728677012,"version":"build-2736575974"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Antimicrobial resistance (AMR) is a growing threat to global public health. In hospitals, infant mortality due to bacterial sepsis is associated with AMR. The epidemiology of AMR in Bolivia (a lower-middle-income country) has not been sufficiently discussed. The aim of this study was to analyze AMR patterns over 8 years at a pediatric hospital in patients with hospital-acquired bloodstream infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a retrospective and analytical revision of AMR in bacteria isolated from blood cultures, performed between 2012 and 2019, in a pediatric hospital in Bolivia. Data analysis was conducted with Stata v14.0, and Fisher\u2019s exact tests were used to determine statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Four hundred and fifty-five (7.2%) positive blood cultures were identified from 6315 blood culture reports between 2012 and 2019.\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      was the most frequently isolated bacteria and showed a significant change in its AMR profile over the 8 years of the study. Gram-negative bacteria and\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      were also frequently isolated, and all demonstrated high levels of resistance to commonly used antibiotics. Overall, most of the clinically important microorganisms had high rates of AMR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      In the present study, we report that isolated bacteria showed significant resistance to multiple drugs, and most demonstrated increased resistance over time. Worryingly,\n                      <jats:italic toggle=\"yes\">K<\/jats:italic>\n                      .\n                      <jats:italic toggle=\"yes\">pneumoniae<\/jats:italic>\n                      showed an increasing resistance to commonly used antibiotics. Overall, despite the limitations, our study, which is one of the first of its kind in Bolivia, demonstrates the need for stricter policies of antibiotic stewardship in similar settings due to the global threat of AMR.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jgid.jgid_130_24","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T04:08:38Z","timestamp":1743394118000},"page":"10-16","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Antimicrobial Resistance in Hospital-acquired Bloodstream Infections among Children in a Pediatric Hospital in Bolivia"],"prefix":"10.4103","volume":"17","author":[{"given":"Diana","family":"Rodriguez","sequence":"first","affiliation":[{"name":"School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Equilia","sequence":"additional","affiliation":[{"name":"School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Roca","sequence":"additional","affiliation":[{"name":"Research Department, Universidad Cristiana de Bolivia, Santa Cruz, Bolivia"},{"name":"Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Ludi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Emory University, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grover","family":"Espada","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Dr. Mario Ortiz Suarez, Santa Cruz, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulma","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Dr. Mario Ortiz Suarez, Santa Cruz, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca","family":"Machuca","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Dr. Mario Ortiz Suarez, Santa Cruz, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taryn","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, SUNY Downstate Medical Center & Kings County Hospital Center, New York, NY, USA"},{"name":"Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"},{"name":"A.B Prisma, Lima, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Gilman","sequence":"additional","affiliation":[{"name":"Department 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