Gashegu, MisbahNdahindwa, VedasteRwagasore, EdsonTuyishime, AlbertMusanabaganwa, ClarisseGahamanyi, NoelMukagatare, IsabelleMbarushimana, DjibrilGreen, Christopher AirdDzinamarira, TafadzwaAhmed, AymanMuvunyi, Claude Mambo2025-03-072025-03-072024-11Gashegu, M.; Ndahindwa, V.; Rwagasore, E.; Tuyishime, A.; Musanabaganwa, C.; Gahamanyi, N.; Mukagatare, I.; Mbarushimana, D.; Green, C.A.; Dzinamarira, T.; et al. Diversity, Distribution, and Resistance Profiles of Bacterial Bloodstream Infections in Three Tertiary Referral Hospitals in Rwanda Between 2020 and 2022. Antibiotics 2024, 13, 1084. https://doi.org/10.3390/antibiotics13111084.2079-6382 (online)10.3390/antibiotics13111084http://hdl.handle.net/2263/101372DATA AVAILABITY STATEMENT: All data produced in this study are included in the published paper.This article forms part of a special issue titled ' The Epidemiology of Antimicrobial Resistance in Bloodstream Infections: Focus on Activity of New Antibiotics'.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.en© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).Prescription and use of antibioticsAMR stewardshipGram-negative bacteriaGram-positive bacteriaHealth facility-acquired infectionSDG-03: Good health and well-beingSDG-06: Clean water and sanitationBacterial bloodstream infection (BSI)Integrated one health policyAntimicrobial resistance (AMR)Article