Abstract
Background Bloodstream infections are among the top causes of morbidity and mortality in people of all ages, especially in immunocompromised patients in sub-Saharan Africa. This study aimed at describing the epidemiology of bloodstream infections and antimicrobial susceptibility pattern over a nine-year period at St. Dominic Hospital, Akwatia, in the Eastern Region of Ghana. Method This study retrospectively analysed data from 4,489 patients who were referred to the Laboratory Department for blood culture and sensitivity testing from January 2009 to December 2017. Sociodemographic data included age, gender, and patients' department. Blood culture results were retrieved from archival records in the laboratory. The authorities of St. Dominic Hospital granted approval for the study. Results The incidence of bloodstream infection over the 9 years was 51.4 positive cultures per 100,000 hospital attendance. Staphylococcus aureus was the leading causative agent of bacteraemia for the first two scalar years (2009–2011 (38.9%) and 2012–2014 (42.2%)) while coagulase-negative staphylococcus (CoNS) (50.5%) was predominant for the last scalar year (2015–2017), followed by Staphylococcus aureus (169/587 (28.8%)). The highest incidence of bloodstream infections was recorded in the wet seasons (months of May (8.9 per 10,000 persons) and October (10.1 per 10,000 persons)). The bacterial isolates demonstrated high resistance to tetracyclines (390/531 (73.4%)), penicillins (1282/1669 (76.8%)), and sulphonamides (450/499 (90.2%)). Conclusion Bloodstream infection and antimicrobial resistance are high in patients seeking healthcare in Akwatia. This therefore calls for concerted efforts aimed at reducing the incidence in the study area.
Highlights
Bloodstream infections are the leading cause of morbidity and mortality in people of all ages [1], in immunocompromised patients [2]. ese infections are frequent and present life-threatening conditions in hospital settings [3, 4]
Bloodstream infections are characterized by the presence of viable bacterial or fungal microorganisms in the Journal of Tropical Medicine bloodstream that elicit inflammatory response and often accompanied by alteration of clinical, laboratory, and haemodynamic parameters [11]. ese microorganisms may include Gram-negative bacteria such as Escherichia coli, Pseudomonas aeruginosa, Klebsiella species, Neisseria meningitidis, and Haemophilus influenzae, and Gram-positive bacteria such as coagulase-negative staphylococci (CoNS), Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, and Enterococcus faecium [12]. e incidence of bloodstream infection is attributed to ageing of patients on admission, increasing number of patients with compromised immunity, and the acquisition of virulence factors by bloodstream pathogens [13, 14] as well as factors linked to infection prevention and control measures and implementation [15]
Bloodstream infections can be categorized into three groups based on its mode of occurrence: in immunocompetent host with intact defenses, in patients at the extremes of life, and in patients affected by pathological conditions putting them at risk to the infections [11]. e symptoms associated with bloodstream infections include, but are not limited to, fever, chills, reduced vascular tone, low blood pressure, change in mental status, hyperventilation, hypothermia, excessive sweating, and likelihood of organ dysfunction [2]
Summary
Bloodstream infections are the leading cause of morbidity and mortality in people of all ages [1], in immunocompromised patients [2]. ese infections are frequent and present life-threatening conditions in hospital settings [3, 4]. In the determination of causative agents of bloodstream infection, blood cultures are the method of choice because they are highly sensitive and easier to perform [16, 17]. The epidemiological pattern of the causative agents is not static but constantly changing over time [19], necessitating the need for frequent surveillance among the populace Due to these reasons, this study aimed at describing the epidemiology and antimicrobial susceptibility patterns of bloodstream bacterial infections over a nine-year period at St. Dominic Hospital, Akwatia, in the Eastern Region of Ghana. Is study aimed at describing the epidemiology of bloodstream infections and antimicrobial susceptibility pattern over a nine-year period at St. Dominic Hospital, Akwatia, in the Eastern Region of Ghana. Bloodstream infection and antimicrobial resistance are high in patients seeking healthcare in Akwatia. is calls for concerted efforts aimed at reducing the incidence in the study area
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