title: Salmonella Bacteremia Among Children in Central and Northwest Nigeria, 2008-2015.
abstract: BACKGROUND
  Etiologic agents of childhood bacteremia remain poorly defined in Nigeria. The absence of such data promotes indiscriminate use of antibiotics and delays implementation of appropriate preventive strategies.
  
  
  METHODS
  We established diagnostic laboratories for bacteremia surveillance at regional sites in central and northwest Nigeria. Acutely ill children aged <5 years with clinically suspected bacteremia were evaluated at rural and urban clinical facilities in the Federal Capital Territory, central region and in Kano, northwest Nigeria. Blood was cultured using the automated Bactec incubator system.
  
  
  RESULTS
  Between September 2008 and April 2015, we screened 10,133 children. Clinically significant bacteremia was detected in 609 of 4051 (15%) in the northwest and 457 of 6082 (7.5%) in the central region. Across both regions, Salmonella species account for 24%-59.8% of bacteremias and are the commonest cause of childhood bacteremia, with a predominance of Salmonella enterica serovar Typhi. The prevalence of resistance to ampicillin, chloramphenicol, and cotrimoxazole was 38.11%, with regional differences in susceptibility to different antibiotics but high prevalence of resistance to readily available oral antibiotics.
  
  
  CONCLUSIONS
  Salmonella Typhi is the leading cause of childhood bacteremia in central Nigeria. Expanded surveillance is planned to define the dynamics of transmission. The high prevalence of multidrug-resistant strains calls for improvement in environmental sanitation in the long term and vaccination in the short term.
authors.affiliation: Division of Pediatric Infectious Diseases Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha International Foundation Against Infectious Diseases in Nigeria, Abuja Department of Pediatrics Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada.
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Obaro
authors.affiliation: Department of Pediatrics.
authors.forename: Fatimah
authors.initials: F
authors.lastname: Hassan-Hanga
authors.affiliation: Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada.
authors.forename: Eyinade K
authors.initials: EK
authors.lastname: Olateju
authors.affiliation: Department of Pediatrics, Nyanya General Hospital.
authors.forename: Dominic
authors.initials: D
authors.lastname: Umoru
authors.affiliation: Zankli Medical Center, Utako.
authors.forename: Lovett
authors.initials: L
authors.lastname: Lawson
authors.affiliation: International Foundation Against Infectious Diseases in Nigeria, Abuja.
authors.forename: Grace
authors.initials: G
authors.lastname: Olanipekun
authors.affiliation: Department of Pediatrics Department of Medical Microbiology, Aminu Kano Teaching Hospital.
authors.forename: Sadeeq
authors.initials: S
authors.lastname: Ibrahim
authors.affiliation: Department of Medical Microbiology, Aminu Kano Teaching Hospital.
authors.forename: Huda
authors.initials: H
authors.lastname: Munir
authors.affiliation: Department of Medical Microbiology, Aminu Kano Teaching Hospital.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Ihesiolor
authors.affiliation: Department of Pediatrics, Wuse General Hospital, Abuja, Federal Capital Territory.
authors.forename: Augustine
authors.initials: A
authors.lastname: Maduekwe
authors.affiliation: Department of Pediatrics, Federal Medical Center, Keffi, Nassarawa State.
authors.forename: Chinatu
authors.initials: C
authors.lastname: Ohiaeri
authors.affiliation: Department of Pediatrics, Asokoro General Hospital.
authors.forename: Anthony
authors.initials: A
authors.lastname: Adetola
authors.affiliation: Department of Pediatrics, National Hospital, Central Business Area, Abuja, Federal Capital Territory.
authors.forename: Denis
authors.initials: D
authors.lastname: Shetima
authors.affiliation: Department of Pediatrics, Murtala Specialist Hospital.
authors.forename: Binta W
authors.initials: BW
authors.lastname: Jibir
authors.affiliation: Hasiya Bayero Pediatric Hospital, Kano.
authors.forename: Hafsat
authors.initials: H
authors.lastname: Nakaura
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Kocmich
authors.affiliation: International Foundation Against Infectious Diseases in Nigeria, Abuja.
authors.forename: Therasa
authors.initials: T
authors.lastname: Ajose
authors.affiliation: International Foundation Against Infectious Diseases in Nigeria, Abuja Department of Microbiology, Bingham University, Karu, Nassarawa State.
authors.forename: David
authors.initials: D
authors.lastname: Idiong
authors.affiliation: Hospital Services Management Board, Kano.
authors.forename: Kabir
authors.initials: K
authors.lastname: Masokano
authors.affiliation: International Foundation Against Infectious Diseases in Nigeria, Abuja.
authors.forename: Adeyemi
authors.initials: A
authors.lastname: Ifabiyi
authors.affiliation: National Primary Health Care Development Agency, Abuja, Federal Capital Territory, Nigeria.
authors.forename: Nnenna
authors.initials: N
authors.lastname: Ihebuzor
authors.affiliation: Department of Biostatistics, College of Public Health.
authors.forename: Baojiang
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Biostatistics, College of Public Health.
authors.forename: Jane
authors.initials: J
authors.lastname: Meza
authors.affiliation: International Foundation Against Infectious Diseases in Nigeria, Abuja.
authors.forename: Adebayo
authors.initials: A
authors.lastname: Akindele
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: Amy
authors.initials: A
authors.lastname: Rezac-Elgohary
authors.affiliation: Division of Pediatric Infectious Diseases.
authors.forename: Rasaq
authors.initials: R
authors.lastname: Olaosebikan
authors.affiliation: Department of Pediatrics, Murtala Specialist Hospital.
authors.forename: Salman
authors.initials: S
authors.lastname: Suwaid
authors.affiliation: Department of Pediatrics.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Gambo
authors.affiliation: Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Alter
authors.affiliation: Division of Pediatric Infectious Diseases Department of Biostatistics, College of Public Health Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha.
authors.forename: Herbert D
authors.initials: HD
authors.lastname: Davies
authors.affiliation: Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Fey
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D009549:Nigeria / Q000453:epidemiology; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology*; D012482:Salmonella paratyphi A / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D012485:Salmonella typhi / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D014435:Typhoid Fever / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Nigeria; Salmonellae; antibiotic resistance; bacteremia; children