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J Gandhara Med Dent Sci

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FREQUENCY OF POSITIVE BLOOD CULTURES AND PATHOGEN DISTRIBUTION AMONG

FEBRILE PATIENTS ADMITTED TO NORTHWEST GENERAL HOSPITAL, PESHAWAR

Gul Rukhsar

1

,

Wafa Khan

2

,

Zainab Kamal

2

,

Wiqar Ahmad

3

, Sanam Fida

1

, Medrar Ullah Khan

4

Rukhsar G, Khan W, Kamal Z, Ahmad

W, Fida S, Khan MU. Frequency of

Positive Blood Cultures and Pathogen

Distribution Among Febrile Patients

Admitted to Northwest General

Hospital, Peshawar. J Gandhara Med

Dent Sci. 2026;13(4):30-35.

Date of Submission:

12-02-2026

Date Revised:

15-09-2026

Date Acceptance:

16-09-2026

2

Medical Officer, Department of

GeneralMedicine, Northwest General

Hospital & Research Center, Peshawar

3

Assistant Professor, Department of

General Medicine, Northwest General

Hospital & Research Center, Peshawar

4

Senior Registrar, Department of General

Medicine, Northwest General Hospital

& Research Center, Peshawar

Correspondence

1

Gul Rukhsar, Post Graduate Resident,

Department of Medicine, Northwest

General Hospital & Research Center,

Peshawar

+92-333-9232951

gulrukhsar7@gmail.com

ABSTRACT

OBJECTIVES

To

determine

the

frequency

of

positive

blood

cultures,

describe

the

distribution of clinically signiﬁcant pathogens, and compare selected clinical

outcomes according to blood-culture status among febrile adult inpatients at

Northwest General Hospital, Peshawar.

METHODOLOGY

This prospective observational cohort study enrolled 129 consecutive febrile

patients aged 18-90 years admitted to the Department of General Medicine

from

January

to

June

2025.

Two

blood-culture

sets

were

collected

using

aseptic

technique

and

processed

in

an

automated

culture

system.

Positive

bottles underwent Gram staining, subculture, and organism identiﬁcation by

matrix-assisted laser desorption ionisation time-of-ﬂight mass spectrometry.

Patients

were

followed

until

discharge

or

in-hospital

death.

Data

were

analysed using SPSS version 25, with appropriate non-parametric and exact

tests; p<0.05 was considered signiﬁcant.

RESULTS

Blood cultures were positive in 50/129 patients (38.8%). Enterobacteriaceae

accounted for 48.0% of positive cultures, Gram-positive cocci for 40.0%, and

non-fermenting Gram-negative rods for 12.0%. Staphylococcus aureus was

the most frequent species (22.0%). Carbapenems (31.0%) and cephalosporins

(27.9%) were the most frequently prescribed antimicrobial classes. Culture-

positive patients were less often male (48.0% vs 70.9%; p=0.015), had lower

median

diastolic

blood

pressure

(70

vs

80

mmHg;

p=0.004),

and

longer

median

hospital

stay

(4

vs 3

days;

p=0.043).

Mortality

was

higher

among

culture-positive

patients

(20.0%

vs

10.1%),

although

not

statistically

signiﬁcant(p=0.126).

CONCLUSION

Bloodstream infection was frequent among febrile inpatients, with substantial

Gram-negative

and

Gram-positive

pathogen

burdens.

The

ﬁndings

support

timely

blood-culture

sampling,

careful

interpretation,

and

strengthened

antimicrobial

stewardship.

Local

surveillance

of

pathogen

distribution

and

resistance

should

guide

empiric

therapy

and

institutional

antibiotic

prescribing

in

this

hospital

population.

KEYWORDS:

Fever,

Blood

Culture,

Bloodstream

Infection,

Bacteremia,

Antimicrobial

Stewardship,

Enterobacteriaceae,

Mortality

INTRODUCTION

Fever

is

a

common

occurrence

among

hospitalised

patients,

accounting

for

2

to

29%

of

all

hospital

admissions,

and

is

frequently

used

as

a

clinical

justification

for

blood

culture.

1

Blood

culture

is

the

current

established

method

for

diagnosing

suspected

cases

of

bacteremia.

When

bacteremia

is

suspected,

most

high-income

countries

regularly

obtain

blood

cultures (BC) from febrile patients (FP).

2

The reported

prevalence

of

positive

BC

among

hospitalised

FP

ranges from 5 to 15%.

3,4

However, due to insuﬃcient

or lacking laboratory capacity, doctors can opt to treat

patients

with

antibiotics

empirically.

In

resource-

constrained settings, especially in South Asia, BC are a

rapidly

growing

resource

that

can

inform

appropriate

treatment

and

encourage

antimicrobial

stewardship.

5,6

Given

the

World

Health

Organisation's

global

action

plan to combat antimicrobial resistance (AMR) and the

knowledge

of

how

AMR

impacts

the

attainment

of

Sustainable Development Goals, a better understanding

of

the

relationship

between

prescribed

antimicrobials,

blood

culture

use,

and

clinician

decision-making

can

help

direct

interventions

to

address

AMR.

7,8

Clinical

decisions,

such

as

choosing

the

right

antibiotic

if

necessary, can be guided by antimicrobial susceptibility

information obtained from BC. 2 BC were underutilised

among

FP

in

low-

and

middle-income

countries

(LMICs)

and

among

patients

who

were

ultimately

found to be bacteremic, according to an earlier study.

9

ORIGINAL ARTICLE

http://doi.org/10.37762/jgmds.13-4.867

31

J Gandhara Med Dent Sci

October - December 2026

BC for febrile cases when bacteremia is suspected may

not be ordered in many LMICs for a number of reasons,

such

as

the

assay's

low

sensitivity,

high

cost,

and the

lengthy

time

it

takes

to

obtain

results.

These

factors

may deter clinicians from ordering cultures in settings

like outpatient departments,

where

many patients

may

not

return

or

be

reachable

for

follow-up.

10

False

positive BC are linked to inappropriate antibiotic

use,

greater downstream testing, higher healthcare costs, and

longer

hospital

stays.

One

investigation

on

BC

of

febrile

patients

found

that

3.1%

of

the

BC

were

true

positive,

with

an

8.5%

diagnostic

yield.

The

most

frequently

isolated

pathogens

were

Staphylococcus

aureus

(22.0%),

Enterobacterales

(17.8%),

coagulase-

negative

Staphylococcus

spp.

(16.3%),

enterococci

(10.2%),

and

Candida

spp(7.0%).

1

This

study

aims

to

evaluate the diagnostic yield of BC among FP admitted

to

Northwest

General

Hospital.

While

blood-culturing

practices

vary

across

clinical

roles

and

experience

levels,

the

non-clinical

factors

inﬂuencing

culture

decisions remain underexplored. Given the importance

of BC in identifying pathogens and guiding appropriate

treatment,

this

research

seeks

to

determine

the

frequency of positive cultures and identify the isolated

pathogens.

The

ﬁndings

will

support

evidence-based

practices,

improve

patient

outcomes,

and

enhance

antibiotic stewardship and resource utilisation.

METHODOLOGY

This

prospective

observational

cohort

study

was

conducted

in

the

Department

of

General

Medicine,

Northwest

General

Hospital

&

Research

Centre,

Peshawar,

from

January

to

June

2025.

Consecutive

patients meeting the eligibility criteria were enrolled at

hospital admission and followed until discharge or in-

hospital

death.

The

study

was

conducted

after

institutional

ethical

clearance,

and

written

informed

consent

was

obtained

from

all

participants

before

enrollment.

Conﬁdentiality

was

maintained

through

coded

study

records.

The

sample

size

was

calculated

using an anticipated blood-culture positivity of 3.1%, a

95% conﬁdence level, and an absolute precision of 3%,

yielding

a

target

close

to

the

ﬁnal

enrollment

of

129

patients.

Adults

of

either

sex

aged

18-90

years

with

documented fever at admission were eligible. Fever was

defined as an oral temperature of at least 38.0°C or a

rectal temperature of at least 38.3°C. Patients who had

received

systemic

antibiotics

within

the

preceding

48

hours,

patients

with

major

immunocompromising

conditions such as HIV infection, chemotherapy, organ

transplantation

or

neutropenia,

and

patients

with

localised

infections

for

which

blood

culture

was

not

routinely indicated

were excluded. Baseline data

were

recorded on a structured proforma. They included age,

sex,

body

mass

index,

residence,

educational

attainment, occupation, socioeconomic status, comorbid

conditions,

admission

temperature,

heart

rate,

respiratory

rate,

systolic

and

diastolic

blood

pressure,

duration

of

febrile

illness,

presenting

symptoms,

and

hospital

length

of

stay.

Hospital

outcome

was

categorised as discharge after clinical improvement or

in-hospital

death.

Because

outcome

status

was

determined from the index admission record, complete

in-hospital outcome data were available for all enrolled

participants. Blood cultures were obtained at enrollment

and, when clinically feasible, before the ﬁrst in-hospital

dose

of

antimicrobial

therapy.

Trained

nursing

staﬀ

performed

venipuncture

after

chlorhexidine

skin

antisepsis.

Two

culture

sets

were

collected

from

separate

venipuncture

sites,

with

each

set

containing

one aerobic and one anaerobic bottle. Approximately 8-

10

mL

of

blood

was

inoculated

into

each

bottle,

providing

an

intended

total

culture

volume

of

approximately 32-40 mL per patient. The two sets were

collected

approximately

20-30

minutes

apart

and

transported

promptly

to

the

microbiology

laboratory.

Blood-culture

bottles

were

incubated

in

an

automated

blood-culture

system

and

monitored

for

microbial

growth for

up to ﬁve days. Bottles ﬂagged as positive

underwent

Gram

staining

and

subculture.

Organism

identification was performed using matrix-assisted laser

desorption/ionisation

time-of-flight

mass

spectrometry

(MALDI-TOF

MS).

Isolates

were

interpreted

as

clinically signiﬁcant bloodstream infection or probable

contamination

according

to

organism

identity,

the

number of positive bottles or sets, repeat cultures when

available,

and

the

clinical

picture.

Coagulase-negative

staphylococci,

Corynebacterium

species,

Bacillus

species other than B. anthracis, and other typical skin

flora

were

considered

probable

contaminants

when

isolated from only one bottle or set without supporting

clinical

or

microbiological

evidence.

A

clinically

relevant

pathogen,

repeated

isolation

of

the

same

organism,

or

concordant

microbiological

and

clinical

findings

supported

classiﬁcation

as

true

bloodstream

infection.

Polymicrobial

cultures

were

counted

as

one

culture-positive

episode

while

each

clinically

significant

organism

was

recorded

for

pathogen

distribution.

Antimicrobial

prescriptions

during

the

admission

were

grouped

by

antibiotic

class.

Because

individual patients could receive more than one agent,

antimicrobial percentages were not mutually exclusive

and therefore did not sum to 100%. The study did not

have suﬃciently detailed time-stamped prescribing data

to separate empiric treatment from subsequent culture-

directed

therapy

reliably;

accordingly,

antibiotic

use

was

described

rather

than

interpreted

as

a

measure

of

appropriateness. Data

were analysed using IBM SPSS

Statistics

version

25.

All

tests

were

two-sided,

and

p<0.05 was considered statistically signiﬁcant.

Frequency of Positive Blood Cultures and Pathogen Distribution

32

J Gandhara Med Dent Sci

October - December 2026

RESULTS

A

total

of

129

febrile

inpatients

were

included.

The

median age was 57 years (IQR 32-70), and 80 (62.0%)

participants

were

male.

The

median

body

mass

index

was 24.6 kg/m² (IQR 21.8-27.1). Diabetes mellitus was

documented in 68 (52.7%) patients and hypertension in

57

(44.2%).

At

presentation,

median

temperature

was

100.5°F

(IQR

100-101),

median

heart

rate

was

94

beats/min,

and

median

systolic

and

diastolic

blood

pressures were 120 and 76 mmHg. Length of hospital

stay (days, median (IQR): 3 (2-6). Regarding antibiotic

prescriptions,

carbapenems

were

the

most

frequently

prescribed antimicrobial class (40, 31.0%), followed by

cephalosporins

(36,

27.9%)

and

ﬂuoroquinolones

(20,

15.5%).

Penicillins

and

no

antibiotic

were

each

prescribed to 19 (14.7%) patients, while glycylcyclines

and

macrolides

were

prescribed

to

11

(8.5%)

patients

each.

Other

prescribed

antimicrobial

classes

included

glycopeptides

(9,

7.0%),

lipopeptides

(8,

6.2%),

peptides

(8,

6.2%),

oxazolidinones

(6,

4.7%),

and

aminoglycosides (2, 1.6%). Patients could receive more

than

one

antimicrobial

agent.

Among

the

50

patients

with positive blood cultures, 10 (20.0%) died, while 40

(80.0%)

improved

and

were

discharged

(Table

4).

In

comparison,

when

the

entire

cohort

of

129

febrile

patients

was

considered,

18

(14.0%)

died,

and

111

(86.0%)

improved

and

were

discharged.

Of

the

79

patients with no growth/not identiﬁed, 8 (10.1%) died,

and

71

(89.9%)

improved

and

were

discharged.

The

duration of hospital stay ranged from 0 to 15 days, with

a mean duration of 5.23 ± 7.75 days and a median of 4

days.

Table 1: Baseline Characteristics of the Study Participants(n=129)

Variable

n (%age)

Gender

Male

80 (62.0)

Female

49 (38.0)

Socioeconomic status

Lower-middle

55 (42.6)

Upper-middle

59 (45.7)

High

15 (11.6)

Comorbid

Diabetes mellitus

68 (52.7)

Hypertension

57 (44.2)

Typhoid

12 (9.3)

Figure 1:

Presenting Symptoms of Patients

Table

2:

Frequency

of

Positive

Blood

Cultures,

Microbial

Isolates, and Antibiotics Prescribed

Variable

n (%age)

Blood culture status

Positive blood culture

50 (38.8)

No growth/not identiﬁed

79 (61.2)

Microbial isolates

among entire cohort

(n=129)

Non-fermenting Gram-

negative rods

6 (4.7)

Gram-positive cocci

20 (15.5)

Enterobacteriaceae

24 (18.6)

Microbial isolates

among culture-

positive patients

(n=50)

Non-fermenting Gram-

negative rods

6 (12.0)

Gram-positive cocci

20 (40.0)

Enterobacteriaceae

24 (48.0)

Note:

Percentages

for

microbial

isolates

in

the

ﬁrst

section use

the

entire study cohort (n=129) as the denominator, whereas percentages

under "microbial isolates among culture-positive patients" use n=50

as the denominator.

Table

3:

Species-Level

Distribution

of

Microorganisms

Isolated

from Positive Blood Cultures

Organism identiﬁed

N

% of positive

cultures (n=50)

% of total

sample (n=129)

Staphylococcus aureus

11

22

8.5

Staphylococcus epidermidis

7

14

5.4

Escherichia coli

6

12

4.7

Enterobacter spp.

7

14

5.4

Providencia spp.

6

12

4.7

Salmonella typhi

4

8

3.1

Acinetobacter spp.

2

4

1.6

Pseudomonas aeruginosa

1

2

0.8

Pseudomonas spp.

1

2

0.8

Klebsiella spp.

1

2

0.8

Enterococcus spp.

2

4

1.6

Pantoea spp.

2

4

1.6

Table 4: Association Between Blood Culture Isolate and Hospital

Outcome Among Culture-Positive Patients

Blood

culture

isolate

Mortli

ty

Improved/

discharged

Total

RR (95

% CI)

p-value

n (%age)

Non-

fermenting

Gram-

negative rods

2

(33.3)

4

(66.7)

6

(100.

0)

1.83

(0.50

–

6.68)

0.116

Gram-

positive

cocci

6

(30.0)

14

(70.0)

20(100

.0)

2.25(0.73

– 6.98)

Enterobacteri

aceae

2

(8.3)

22

(91.7)

24(100

.0)

0.27(0.06

– 1.15)

Total

10

(20.0)

40

(80.0)

50(100

.0)

--

Note: Mortality (%) is calculated within each organism category. RR

compares the mortality risk for each organism category with all other

culture-positive

organism

categories

was

small.

have

reported

diﬀerences

in

mortality

according

to

bloodstream

pathogen

characteristics.

21,22,23

However,

direct

comparison with our ﬁndings is limited by diﬀerences

in

patient

populations,

clinical

severity,

and

study

design.

LIMITATIONS

This

was

a

single-centre

study

with

a

relatively small

sample size, which limits generalizability and statistical

precision. Patients who had received antibiotics within

the

preceding

48

hours

and

several

immunocompromised

populations

were

excluded;

consequently, the ﬁndings should not be extrapolated to

all

febrile

medical

inpatients.

Detailed

antimicrobial

susceptibility

data,

infection

source,

severity

scores,

time

to

positivity,

and

time-stamped

antimicrobial

changes

were

not

available

for

complete

analysis.

Although contamination was assessed using clinical and

microbiological

criteria,

some

isolates

such

as

coagulase-negative

staphylococci

remain

diﬃcult

to

classify

without

complete

device

and

repeat-culture

information. The study measured in-hospital outcomes

only

and

did

not

include

post-discharge

mortality

or

readmission.

Multivariable

modelling

was

not

Frequency of Positive Blood Cultures and Pathogen Distribution

34

J Gandhara Med Dent Sci

October - December 2026

undertaken,

so

observed

group

diﬀerences

may

be

inﬂuenced

by

unmeasured

confounding.

Future

multicentre

studies

should

integrate

antimicrobial

susceptibility,

antibiotic

timing,

stewardship

interventions, source of infection, severity adjustment,

and longer follow-up.

CONCLUSIONS

Positive

blood

cultures

were

common

among

febrile

inpatients

at

Northwest

General

Hospital,

with

Enterobacteriaceae and Gram-positive cocci accounting

for most clinically signiﬁcant isolates.

Culture-positive

patients

had

longer

hospital

stays

and

numerically

higher mortality, although the mortality diﬀerence was

not

statistically

signiﬁcant.

Frequent

use

of

carbapenems and cephalosporins reinforces the need to

connect

high-quality

blood-culture

practice

with

local

resistance

surveillance

and

antimicrobial-stewardship

programmes.

CONFLICT OF INTEREST:

None

FUNDING SOURCES:

None

REFERENCES

1.

Foong

KS,

Munigala

S,

Kern-Allely

S,

Warren

DK.

Blood

culture

utilisation

practices

among

febrile

and/or

hypothermic

inpatients.

BMC

Infect

Dis.

2022;22(1):779.

doi:10.1186/s12879-022-07748-x. PMID: 36217111.

2.

Ombelet S, Ronat JB, Walsh T, Yansouni CP, Cox J, Vlieghe E,

et

al.

Clinical

bacteriology

in

low-resource

settings:

today's

solutions.

Lancet

Infect

Dis.

2018;18(8).

doi:10.1016/S1473-

3099(18)30093-8. PMID: 29519767.

3.

Ingle

DJ,

Levine

MM,

Kotloﬀ

KL,

Holt

KE,

Robins-Browne

RM.

Dynamics

of

antimicrobial

resistance

in

intestinal

Escherichia coli from children in community settings in South

Asia

and

sub-Saharan

Africa.

Nat

Microbiol.

2018;3(9):1063-

1073. doi:10.1038/s41564-018-0217-4. PMID: 30127495.

4.

Linsenmeyer

K,

Gupta

K,

Strymish

JM,

Dhanani

M,

Brecher

SM, Breu AC. Culture if spikes? Indications and yield of blood

cultures

in

hospitalised

medical

patients.

J

Hosp

Med.

2016;11(5):336-340. doi:10.1002/jhm.2541. PMID: 26762577.

5.

Lamy B, Dargère S, Arendrup MC, Parienti JJ, Tattevin P. How

to

optimise

the

use

of

blood

cultures

for

the

diagnosis

of

bloodstream

infections?

A

state-of-the-art.

Front

Microbiol.

2016;7:697. doi:10.3389/fmicb.2016.00697. PMID: 27242721.

6.

Swaminathan S, Prasad J, Dhariwal AC, Guleria R, Misra MC,

Malhotra

R,

et

al.

Strengthening

infection

prevention

and

control

and

systematic

surveillance

of

healthcare-associated

infections

in

India.

BMJ.

2017;358.

doi:10.1136/bmj.j3768.

PMID: 28874366.

7.

World Health Organization. Global action plan on antimicrobial

resistance.

Geneva:

World

Health

Organization;

2015.

PMID:

not available.

8.

Jasovsky

D,

Littmann

J,

Zorzet

A,

Cars

O.

Antimicrobial

resistance—a threat to the world's sustainable development. Ups

J

Med

Sci.

2016;121(3):159-164.

doi:10.1080/03009734.2016.1195900. PMID: 27416324.

9.

Teerawattanasook N, Tauran PM, Teparrukkul P, Wuthiekanun

V, Dance DAB, Arif M, et al. Capacity and utilisation of blood

culture in two referral hospitals in Indonesia and Thailand. Am J

Trop

Med

Hyg.

2017;97(4):1257-1261.

doi:10.4269/ajtmh.17-

0193. PMID: 28722626.

10.

Mogasale V, Ramani E, Mogasale VV, Park J. What proportion

of

Salmonella

Typhi

cases

are

detected

by

blood

culture?

A

systematic

literature

review.

Ann

Clin

Microbiol

Antimicrob.

2016;15(1):32.

doi:10.1186/s12941-016-0147-z.

PMID:

27188991.

11.

Sakurai T, Aiba M, Takahashi M, Sakamoto N, Yang KS, Tsuda

H, et al. Blood culture results in elderly febrile patients. Nihon

Ronen

Igakkai

Zasshi.

2015;52(4):367-373.

doi:10.3143/geriatrics.52.367. PMID: 26700776.

12.

Iqbal H, Mahboob N, Ahmed M, Mamun KZ, Rahim A, Azad

KA.

Bacteriological

proﬁle

and

antimicrobial

susceptibility

patterns

of

blood

culture

isolates

among

febrile

patients

in

a

tertiary

care

hospital,

Bangladesh.

J

Dhaka

Med

Coll.

2018;27(2):114-122. doi:10.3329/jdmc.v27i2.45820.

13.

Ali

J,

Kebede

Y.

Frequency

of

isolation

and

antimicrobial

susceptibility

pattern

of

bacterial

isolates

from

blood

culture,

Gondar

University

Teaching

Hospital,

Northwest

Ethiopia.

Ethiop Med J. 2008;46(2):155-161. PMID: 21309205.

14.

Clearesta

KE,

Gustawan

IW,

Ariawati

K,

Fatmawati

NND,

Utama

MGDL,

Widnyana

AANKP,

et

al.

Microbial

blood

culture patterns and antibiotic susceptibility in pediatric febrile

neutropenia

at

Sanglah

General

Hospital

Bali.

Bali

Med

J.

2022;11(2):962-969. doi:10.15562/bmj.v11i2.3436.

15.

Badshah

A,

Naseer

A,

Ullah

I,

Ishaq

M.

Diagnostic

yield

of

blood cultures among patients admitted with non-focal pyrexias.

J

Gandhara

Med

Dent

Sci.

2024;11(1):26-29.

doi:10.37762/jgmds.11-1.486. PMID: not available.

16.

Sengar M, Kelkar R, Jain H, Biswas S, Pawaskar P, Karpe A.

Frequency

of

bacterial

isolates

and

pattern

of

antimicrobial

resistance

in

patients

with

hematological

malignancies:

a

snapshot

from

a

tertiary

cancer

center.

Indian

J

Cancer.

2014;51(4):456-458.

doi:10.4103/0019-509X.175387.

PMID:

26842160.

17.

Osmani AH, Jabbar AA, Gangwani MK, Hassan B. Outcomes

of high-risk patients with febrile neutropenia at a tertiary care

center.

Asian

Pac

J

Cancer

Prev.

2017;18(10):2741-2745.

doi:10.22034/APJCP.2017.18.10.2741. PMID: 29072402.

18.

Marghoob

B,

Khosravi-Khezri

M.

The

relationship

between

positive

cultures

with

multidrug-resistant

microorganisms

and

mortality

in

a

general

intensive

care

unit.

Avicenna

J

Clin

Microbiol Infect. 2022;9(2):70-76. doi:10.34172/ajcmi.2022.11.

19.

Wasihun

AG,

Wlekidan

LN,

Gebremariam

SA,

Dejene

TA,

Welderufael

AL,

Haile

TD,

et

al.

Bacteriological

proﬁle

and

antimicrobial

susceptibility

patterns

of

blood

culture

isolates

among febrile patients in Mekelle Hospital, Northern Ethiopia.

Springerplus.

2015;4:314.

doi:10.1186/s40064-015-1056-x.

PMID: 26155453.

20.

Chowdhury

F,

Shuvo

TA,

Palit

A,

Rahman

MZ,

Ghosh

RK,

Angra

P,

et

al.

Antibiotic

use

before

and

after

hospital

admission among hospitalised patients with acute febrile illness

in

Bangladesh

[abstract].

Open

Forum

Infect

Dis.

2023;10(Suppl 2).1863. doi:10.1093/oﬁd/ofad500.1863. PMID:

not available.

21.

Agarwal

K,

Kapil

J,

Kumari

PHP.

Study

of

bacterial

agents

causing

febrile

illnesses

in

children

between

1

month

to

12

years

of

age

in

a

tertiary

care

hospital

in

Sikkim.

Int

J

Curr

Microbiol

Appl

Sci.

2020;9(10):1310-1323.

doi:10.20546/ijcmas.2020.910.158.

22.

Søgaard

M,

Nørgaard

M,

Pedersen

L,

Sørensen

HT,

Schønheyder

HC.

Blood

culture

status

and

mortality

among

patients

with

suspected

community-acquired

bacteremia:

a

population-based

cohort

study.

BMC

Infect

Dis.

2011;11:139.

doi:10.1186/1471-2334-11-139. PMID: 21599971.

Frequency of Positive Blood Cultures and Pathogen Distribution

35

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October - December 2026

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23.

Bonadia

N,

Della

Polla

DA,

Murri

R,

D'Inzeo

T,

Fiori

B,

Carnicelli A, et al. Comparative mortality analysis in febrile and

afebrile

emergency

department

patients

with

positive

blood

cultures: a retrospective study. Microbiol Res. 2024;15(3):1073-

1082. doi:10.3390/microbiolres15030070.

Gul

Rukhsar

-

Concept

&

Design;

Data

Acquisition;

Drafting Manuscript; Final Approval

Wafa Khan

-

Concept & Design; Data Acquisition; Data

Analysis/Interpretation;

Drafting

Manuscript;

Critical

Revision; Supervision; Final Approval

Zainab

Kamal

-

Concept

&

Design;

Data

Acquisition;

Data

Analysis/Interpretation;

Drafting

Manuscript;

Supervision;

Final Approval

Wiqar

Ahmad

-

Concept

&

Design;

Data

Acquisition;

Drafting Manuscript; Critical Revision; Final Approval

Sanam Fida

-

Concept & Design; Data Acquisition; Data

Analysis/Interpretation;

Drafting

Manuscript;

Final

Approval

Medrar

Ullah

Khan

-

Concept

&

Design;

Data

Acquisition;

Drafting

Manuscript;

Final

Approval

AUTHORS CONTRIBUTION

The authors accept responsibility for all aspects of the work

and will ensure that any concerns regarding the accuracy or

integrity of any part are properly investigated and resolved.

Frequency of Positive Blood Cultures and Pathogen Distribution