Abstract:
The burden of bacterial bloodstream infections (BSIs) is rapidly increasing
in Africa including Rwanda. Methods: This is a retrospective study that investigates the diversity,
distribution, and antimicrobial susceptibility profiles of BSI bacteria in three tertiary referral hospitals
in Rwanda between 2020 and 2022. Results: A total of 1532 blood culture tests were performed
for visiting patients. Overall, the proportions of Gram-negative and Gram-positive bacteria were
48.2% and 51.8, respectively. Staphylococcus aureus was the predominant species accounting for 25%
of all Gram-positive BSI species, and Klebsiella species represented 41% of all Gram-negative BSI
species. Antimicrobial susceptibility testing revealed that Amikacin exhibited the highest activity
against Enterobacter spp., Serratia spp., and Escherichia coli in >92% of cases and Klebsiella spp. in
75.7%. Meropenem and Imipenem were highly efficacious to Salmonella spp. (100% susceptibility),
Enterobacter spp. (96.2% and 91.7%, respectively), and Escherichia coli (94.7% and 95.5%, respectively).
The susceptibility of Enterococcus spp., S. aureus, and Streptococcus spp. to Vancomycin was 100%,
99.5%, and 97.1%, respectively. Klebsiella spp. was highly sensitive to Colistin (98.7%), Polymyxin B
(85.6%), Imipenem (84.9%), and Meropenem (78.5%). Conclusions: We recommend strengthening
the implementation of integrated transdisciplinary and multisectoral One Health including AMR
stewardship for the surveillance, prevention, and control of AMR in Rwanda.
