Etiologies of bloodstream infection and antimicrobial resistance: A cross sectional study among patients in a tertiary hospital, Northern Tanzania

Abstract

Background: Bloodstream infections are important causes of morbidity and mortality in people of all age groups, especially in sub-Saharan Africa. In Tanzania, a recent report indicates that case fatality rate of 37% is attributed to bloodstream infections. The aim of this study was to determine the prevalence and factors associated with bloodstream infections as well as to determine resistance pattern of bacterial isolates among patients visiting Kilimanjaro Christian Medical Centre (KCMC).

Methods: A cross-sectional study was conducted from April to June 2019 at KCMC. A total of 200 patients were included in the study. Blood samples were collected for culture, malaria rapid test, typhoid and brucella tests. Clinical features, co-morbid conditions and patients' hospitalization data were recorded in the questionnaire. Logistic regression was used to examine the factors associated with bloodstream infections. Predictors of the outcome were considered significant at p<0.05.

Results: The prevalence of bloodstream infections was 52(26%). Participants with stomachache had less odds of having bloodstream infections as compared to other patients with symptoms (AOR=0.22, 5.33, 95%CI=0.05-0.97; p=0.04).  Of the 41 identified isolates, Staphylococcus aureus showed the highest rates of resistance for Meropenem 8 (88.8%), Cefotaxime 6 (66.6%), Amikacin 6 (66.6%), Gentamicin 6 (66.6% (and Imipenem (6 (66.6%). The lowest level of resistance was observed in Ceftriaxone 1(11.1%).

Conclusion: Bloodstream infections were highly prevalent in this sample (26%). Staphylococcus spp was the most commonly isolated organism and exhibited a high resistance rate to most antibiotics. This calls for increased and coordinated efforts to improve the identification, treatment and management of bloodstream infections and antimicrobial resistance, thereby improving clinical practice.