{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:48:01Z","timestamp":1787852881864,"version":"build-2784847793"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,7]]},"abstract":"<jats:title>Abstract.<\/jats:title><jats:p>Invasive <jats:italic>Salmonella<\/jats:italic> infection is a common cause of acute febrile illness (AFI) among children in sub-Saharan Africa; however, diagnosing <jats:italic>Salmonella<\/jats:italic> bacteremia is challenging in settings without blood culture. The Uganda AFI surveillance system includes blood culture-based surveillance for etiologies of bloodstream infection (BSIs) in hospitalized febrile children in Uganda. We analyzed demographic, clinical, blood culture, and antimicrobial resistance data from hospitalized children at six sentinel AFI sites from July 2016 to January 2019. A total of 47,261 children were hospitalized. Median age was 2 years (interquartile range, 1\u20134) and 26,695 (57%) were male. Of 7,203 blood cultures, 242 (3%) yielded bacterial pathogens including <jats:italic>Salmonella<\/jats:italic> (<jats:italic>N<\/jats:italic> = 67, 28%), <jats:italic>Staphylococcus aureus<\/jats:italic> (<jats:italic>N<\/jats:italic> = 40, 17%), <jats:italic>Escherichia<\/jats:italic> spp. (<jats:italic>N<\/jats:italic> = 25, 10%), <jats:italic>Enterococcus<\/jats:italic> spp. (<jats:italic>N<\/jats:italic> = 18, 7%), and <jats:italic>Klebsiella pneumoniae<\/jats:italic> (<jats:italic>N<\/jats:italic> = 17, 7%). Children with BSIs had longer median length of hospitalization (5 days versus 4 days), and a higher case-fatality ratio (13% versus 2%) than children without BSI (all <jats:italic>P<\/jats:italic> &lt; 0.001). Children with <jats:italic>Salmonella<\/jats:italic> BSIs did not differ significantly in length of hospitalization or mortality from children with BSI resulting from other organisms. Serotype and antimicrobial susceptibility results were available for 49 <jats:italic>Salmonella<\/jats:italic> isolates, including 35 (71%) non-typhoidal serotypes and 14 <jats:italic>Salmonella<\/jats:italic> serotype Typhi (Typhi). Among Typhi isolates, 10 (71%) were multi-drug resistant and 13 (93%) had decreased ciprofloxacin susceptibility. <jats:italic>Salmonella<\/jats:italic> strains, particularly non-typhoidal serotypes and drug-resistant Typhi, were the most common cause of BSI. These data can inform regional <jats:italic>Salmonella<\/jats:italic> surveillance in East Africa and guide empiric therapy and prevention in Uganda.<\/jats:p>","DOI":"10.4269\/ajtmh.20-1453","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T18:43:01Z","timestamp":1621276981000},"page":"37-46","source":"Crossref","is-referenced-by-count":21,"title":["Salmonella Bloodstream Infections in Hospitalized Children with Acute Febrile Illness\u2014Uganda, 2016\u20132019"],"prefix":"10.4269","volume":"105","author":[{"given":"Grace D.","family":"Appiah","sequence":"first","affiliation":[{"name":"1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Mpimbaza","sequence":"additional","affiliation":[{"name":"2Infectious Disease Research Collaboration, Kampala, Uganda;"},{"name":"3Child Health and Development Center, Makerere University, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Lamorde","sequence":"additional","affiliation":[{"name":"4Infectious Diseases Institute, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Freeman","sequence":"additional","affiliation":[{"name":"1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Kajumbula","sequence":"additional","affiliation":[{"name":"5Department of Microbiology, Makerere University, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Salah","sequence":"additional","affiliation":[{"name":"1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiersten","family":"Kugeler","sequence":"additional","affiliation":[{"name":"6Division of Vector-Borne Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Mikoleit","sequence":"additional","affiliation":[{"name":"7Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Porscha Bumpus","family":"White","sequence":"additional","affiliation":[{"name":"1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kapisi","sequence":"additional","affiliation":[{"name":"2Infectious Disease Research Collaboration, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Borchert","sequence":"additional","affiliation":[{"name":"6Division of Vector-Borne Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asadu","family":"Sserwanga","sequence":"additional","affiliation":[{"name":"2Infectious Disease Research Collaboration, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Van Dyne","sequence":"additional","affiliation":[{"name":"1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Mead","sequence":"additional","affiliation":[{"name":"6Division of Vector-Borne Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunkyung","family":"Kim","sequence":"additional","affiliation":[{"name":"1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana C.","family":"Lauer","sequence":"additional","affiliation":[{"name":"1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Winstead","sequence":"additional","affiliation":[{"name":"8Division of Parasitic Disease and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukari C.","family":"Manabe","sequence":"additional","affiliation":[{"name":"9Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Flick","sequence":"additional","affiliation":[{"name":"9Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Mintz","sequence":"additional","affiliation":[{"name":"1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/105\/1\/article-p37.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/105\/1\/article-p37.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T15:39:30Z","timestamp":1625758770000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/105\/1\/article-p37.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,7]]},"references-count":0,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-1453","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,7]]}}}