Submission ID 117440
| Issue/Objective | Bloodstream infections (BSIs) are a leading cause of morbidity and mortality. Although blood culture remains the diagnostic gold standard, bacterial pathogens frequently exhibit varying levels of antibiotic resistance. In Liberia, data on BSI are limited, and Maryland County lacks localized antibiotic guidelines. This study reports the causes of BSIs, their antibiotic susceptibility patterns, and suggests empirical treatments for Maryland County, Southeast Liberia. |
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| Methodology/Approach | A descriptive study was conducted using retrospective data from 290 blood cultures collected between February 2020 and March 2024. Bacterial identification and antibiotic susceptibility testing followed standard protocols, including morphological assessment, Gram staining, and biochemical testing using the Analytic Profile Index (API). Antibiotic sensitivity testing was done using the modified disc diffusion method, adhering to the Clinical and Laboratory Standards Institute (CLSI) guidelines (2019). |
| Results | The culture positivity rate was 30%, with significantly more females than males yielding positive isolates (p < 0.0001). Gram-positive bacteria accounted for 51.7% of isolates, primarily Coagulase-Negative Staphylococcus (CoNS) (33.3%) and Staphylococcus aureus (12.6%). Among gram-negative isolates, Klebsiella (14.9%), Acinetobacter (10.3%), and E. coli (6.9%) were the most common. Methicillin-resistant Staphylococcus aureus (MRSA) made up 42.5% of Staphylococcus isolates, and were mainly CoNS (40.0%). Gram-positive isolates were most susceptible to Vancomycin (95.2%), Clindamycin (93.8%), and Ciprofloxacin (85.0%), while gram-negative isolates responded best to Meropenem (100%), Piperacillin-Tazobactam (81.8%), and Imipenem (75.9%). Ampicillin (86.2%) and Penicillin (76.9%) were the most resistant antibiotics for gram-positives, while Amoxyclav (100%), Ampicillin (95.8%), Ceftriaxone (90.9%), and Cotrimoxazole (79.4%) showed high resistance among gram-negatives. MRSA was fully sensitive to Vancomycin (100%), and largely sensitive to Clindamycin (82.4%). |
| Discussion/Conclusion | CoNS was the most common isolate, and all gram-negative bacteria were sensitive to Meropenem. Meropenem and Vancomycin are recommended as first-line empirical therapy, with Ciprofloxacin as a second-line option. Ongoing antibiotic resistance surveillance and local guidelines are crucial. |
| Presenters and affiliations | Arnold Ayebare Partners in Health, Liberia. Ssentamu John Vanglist Partners in Health, Liberia. Leroy N. Kpokpah Partners in Health, Liberia. Lidia S Tefera Partners in Health, Liberia. Bill P. Davis James Jenkins Dossen Hospital C. Peters Maryland County Health Team, Ministry of Health (MOH) L. Tanwone Maryland County Health Team, Ministry of Health (MOH) Siedoh Freeman Maryland County Health Team, Ministry of Health (MOH) John P. Otuba Partners in Health, Liberia. Sterman Toussaint Partners in Health, Liberia. Sarah Anyango Partners in Health, Liberia. Maxo Luma Partners in Health, Liberia. |
