Antimicrobial resistance patterns of bacterial isolates from bloodstream infections at Jinja regional referral hospital: A cross-sectional study

Abstract

Introduction Bloodstream infections are a commonly encountered clinical syndrome of public health concern with variable epidemiology. The characteristic of resistance to multiple antibiotics by their etiologic agents has limited the options for empirical sepsis case management. This study determined the most frequent aetiologic agents responsible for bloodstream infections, their antimicrobial susceptibility patterns, and infection sources in Eastern-Central Uganda. Materials and methods This retrospective study involved analysis of all non-duplicate blood culture reports from 2019 to 2021. The frequency and percentage of significant pathogenic organisms and contaminants were calculated. Positivity distribution including infection sources was determined. World Health Organization Network (WHONET) 2022 desktop software was used for antimicrobial susceptibility data analysis. Results The 1364 participants had a diagnostic yield of 114(6.8%) and a 1.5% contamination rate. Over 37% and 13% of infections were hospital and community-acquired respectively. Most etiologic agents were Gram-positive bacteria dominated by Staphylococcus aureus 39(34.2%). Gram-negatives mainly included unspecified Coliforms 12(10.5%), and E. coli 10(8.8%). Polymicrobial growth existed in 4(0.3%) cases. S. aureus was mainly resistant to Penicillin G (100%), Cefoxitin (60%), and Erythromycin (52.2%). Both Escherichia coli and unspecified coliforms showed high resistance to Ampicillin (87.5%) and third-generation Cephalosporins (100%). The least resistance was to Chloramphenicol and Carbapenems. Conclusion BSIs are mainly due to Gram-positive bacteria. Suspected sepsis cases by S. aureus in this region can be empirically managed using Gentamicin. Microbiology services should be routinely utilized to guide antimicrobial use, monitor blood culture contamination rates and resistance trends to strengthen regional antimicrobial stewardship.