Antimicrobial resistance patterns of isolates from bloodstream infections at Jinja Regional Referral Hospital: A cross-sectional study

Background Bloodstream infections are common acute syndromes of variable origin with high chances for extreme health effects including death. This underscores the essence for their quick management to expedite better outcomes. In this study settings, therapy is predominantly empirical using majorly cefriaxone and/or metronindazole. Agents for empirical therapy are liable to antimicrobial resistance and their choice ought to be routinely guided by microbiology laboratory data. This study determined the most frequent aetiologic agents responsible for bloodstream infections, their antimicrobial susceptibility patterns, and infection sources in Eastern-central Uganda. Patients and methods: The analysis involved all non-duplicate blood culture reports from 2019 to 2021 using World Health Organization Network (WHONET) 2022 desktop software and Microsoft Excel. Results: The 1364 reports showed a diagnostic yield of 114(6.8%) and a 1.5% contamination rate. Over 37% and 13% of infections were hospital-acquired and community-acquired respectively. Most etiologic agents were Gram-positive bacteria dominated by Staphylococcus aureus 39(34.2%). Polymicrobial growth existed in 4(0.3%) cases. S. aureus was mainly resistant to penicillin G(100%) but most susceptible to gentamicin(%S=74.1, 95%C.I:53.4-88.1).  Escherichia coli and unspecified Coliforms together showed high resistance to ampicillin(87.5%) and third-generation cephalosporins(100%). The least resistance was to chloramphenicol and carbapenems. Conclusion: As the most frequent explanatory for septicaemia, S. aureus suspected cases in this region could have higher success with gentamicin involved in the empirical therapy combination for their management. The heightened resistance against ceftriaxone requires its limited use.  Microbiology services should be routinely utilized to guide targeted antimicrobial use, monitor blood culture contamination rates and resistance trends to strengthen regional antimicrobial stewardship.