Bloodstream infections at a tertiary hospital in the Gambia - a one-year retrospective study
Rahden, Paul ; Barrow, Ebrima ; Bah, Haddy ; Bittaye, Sheikh Omar ; Nygren, David LU
and Badjan, Abdoulie
(2025)
In BMC Infectious Diseases
25(1).
- Abstract
Introduction: Antimicrobial resistance is a significant global health concern, particularly in western Sub-Saharan Africa. This study describes causes of bloodstream infections and antimicrobial resistance at a tertiary hospital in The Gambia. Methods: This retrospective analysis included all blood cultures performed at the Edward Francis Small Teaching Hospital, Banjul, The Gambia, from September 2022 to August 2023. Blood culture positivity-rates and pathogens were described. Antimicrobial susceptibility testing was performed using disk diffusion following the Clinical & Laboratory Standards Institute guidelines. Results: A total of 645 patients had blood cultures drawn during the study period with 260 (40%) positive results.... (More)
Introduction: Antimicrobial resistance is a significant global health concern, particularly in western Sub-Saharan Africa. This study describes causes of bloodstream infections and antimicrobial resistance at a tertiary hospital in The Gambia. Methods: This retrospective analysis included all blood cultures performed at the Edward Francis Small Teaching Hospital, Banjul, The Gambia, from September 2022 to August 2023. Blood culture positivity-rates and pathogens were described. Antimicrobial susceptibility testing was performed using disk diffusion following the Clinical & Laboratory Standards Institute guidelines. Results: A total of 645 patients had blood cultures drawn during the study period with 260 (40%) positive results. Contaminants were identified in 28 cases (4%). The majority were drawn from neonatal or paediatric patients (360/645, 56%) and overall primarily in intensive care units (406/645, 63%). The median age was 3 years (interquartile range 0–31 years) and 46% were female. The most common pathogens were Staphylococcus aureus 106/260 (41%), Klebsiella spp. 41/260 (16%), other bacteria within the Enterobacterales order 33/260 (13%), Pseudomonas spp. 22/260 (8%) and Acinetobacter spp. 19/260 (7%). Methicillin-resistant S. aureus (MRSA) was seen in 34/58 (59%) tested. Extended-spectrum beta-lactamases (ESBL) were seen in 36/40 (90%) of Klebsiella spp. and in 16/28 (57%) of other bacteria within the Enterobacterales order. Acquired antibiotic resistance, beyond wild-type, was reported in 17/20 (85%) of Pseudomonas spp. and 16/19 (84%) of Acinetobacter spp. Conclusion: Overall, blood culture positivity rates were high, indicating restrictive testing suggesting that sample collection were restricted to mainly critically ill, neonatal or paediatric patients. Nonetheless, our data suggests a high proportion of bloodstream infections due to multi-drug resistant pathogens, including MRSA and ESBL-Enterobacterales. Importantly, generalisability of findings beyond this tertiary hospital setting remains restricted. However, our findings demonstrate a need for improved diagnostic stewardship and ongoing surveillance to provide robust evidence-based data to inform antimicrobial resistance interventions.
(Less)
- author
- Rahden, Paul
; Barrow, Ebrima
; Bah, Haddy
; Bittaye, Sheikh Omar
; Nygren, David
LU
and Badjan, Abdoulie
- organization
- publishing date
- 2025-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Antimicrobial Resistance, Bacteraemia, Bloodstream infections, Low resource setting, Sub-saharan Africa, The Gambia
- in
- BMC Infectious Diseases
- volume
- 25
- issue
- 1
- article number
- 170
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85218191205
- pmid:39910483
- ISSN
- 1471-2334
- DOI
- 10.1186/s12879-025-10533-1
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © The Author(s) 2025.
- id
- 5f8dd9d0-a472-4eed-b116-9394de0d527a
- date added to LUP
- 2025-05-28 12:08:38
- date last changed
- 2025-05-29 03:00:07
@article{5f8dd9d0-a472-4eed-b116-9394de0d527a,
abstract = {{<p>Introduction: Antimicrobial resistance is a significant global health concern, particularly in western Sub-Saharan Africa. This study describes causes of bloodstream infections and antimicrobial resistance at a tertiary hospital in The Gambia. Methods: This retrospective analysis included all blood cultures performed at the Edward Francis Small Teaching Hospital, Banjul, The Gambia, from September 2022 to August 2023. Blood culture positivity-rates and pathogens were described. Antimicrobial susceptibility testing was performed using disk diffusion following the Clinical & Laboratory Standards Institute guidelines. Results: A total of 645 patients had blood cultures drawn during the study period with 260 (40%) positive results. Contaminants were identified in 28 cases (4%). The majority were drawn from neonatal or paediatric patients (360/645, 56%) and overall primarily in intensive care units (406/645, 63%). The median age was 3 years (interquartile range 0–31 years) and 46% were female. The most common pathogens were Staphylococcus aureus 106/260 (41%), Klebsiella spp. 41/260 (16%), other bacteria within the Enterobacterales order 33/260 (13%), Pseudomonas spp. 22/260 (8%) and Acinetobacter spp. 19/260 (7%). Methicillin-resistant S. aureus (MRSA) was seen in 34/58 (59%) tested. Extended-spectrum beta-lactamases (ESBL) were seen in 36/40 (90%) of Klebsiella spp. and in 16/28 (57%) of other bacteria within the Enterobacterales order. Acquired antibiotic resistance, beyond wild-type, was reported in 17/20 (85%) of Pseudomonas spp. and 16/19 (84%) of Acinetobacter spp. Conclusion: Overall, blood culture positivity rates were high, indicating restrictive testing suggesting that sample collection were restricted to mainly critically ill, neonatal or paediatric patients. Nonetheless, our data suggests a high proportion of bloodstream infections due to multi-drug resistant pathogens, including MRSA and ESBL-Enterobacterales. Importantly, generalisability of findings beyond this tertiary hospital setting remains restricted. However, our findings demonstrate a need for improved diagnostic stewardship and ongoing surveillance to provide robust evidence-based data to inform antimicrobial resistance interventions.</p>}},
author = {{Rahden, Paul and Barrow, Ebrima and Bah, Haddy and Bittaye, Sheikh Omar and Nygren, David and Badjan, Abdoulie}},
issn = {{1471-2334}},
keywords = {{Antimicrobial Resistance; Bacteraemia; Bloodstream infections; Low resource setting; Sub-saharan Africa; The Gambia}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Infectious Diseases}},
title = {{Bloodstream infections at a tertiary hospital in the Gambia - a one-year retrospective study}},
url = {{http://dx.doi.org/10.1186/s12879-025-10533-1}},
doi = {{10.1186/s12879-025-10533-1}},
volume = {{25}},
year = {{2025}},
}