Bloodstream Infections in Ethiopia Reveal High Rates of Multidrug Resistance and Fungal Involvement

Burkholderia cepacia

Image credits: Unsplash

A cross-sectional study presented at ASM Microbe 2025 identified high rates of antimicrobial resistance among bacterial and fungal isolates recovered from blood cultures of patients referred to the Ethiopian Public Health Institute (EPHI). The data underscore growing concerns about treatment efficacy and infection control in low-resource settings.

Researchers analyzed 346 blood samples collected between February and June 2020. Of the 175 pathogens identified, 60% were Gram-negative bacteria, 30.9% Gram-positive, and 9.1% fungal. The most commonly isolated Gram-negative species was Burkholderia cepacia, while coagulase-negative Staphylococcus predominated among Gram-positives. Candida krusei accounted for over half of the fungal isolates.

Antimicrobial susceptibility testing using Kirby-Bauer and Vitek 2 systems revealed alarming resistance trends. Third-generation cephalosporins and penicillins showed the highest resistance rates among bacteria. Klebsiella pneumoniae displayed 71.4% multidrug resistance (MDR), followed by Acinetobacter spp. at 85.7%. Fungal isolates, particularly C. krusei, showed resistance to fluconazole.

Statistical analysis identified significant associations between bloodstream infections and patient sex (P = 0.007), age (P < 0.001), and use of invasive devices (P = 0.003). The study also noted that K. pneumoniae and Acinetobacter spp. exhibited resistance to multiple classes of antibiotics, including carbapenems and aminoglycosides, raising concern for potential treatment limitations in critical care settings.

The findings call attention to the need for targeted infection control measures, environmental hygiene improvements, and robust local antimicrobial stewardship programs. The authors emphasized that identifying regional pathogen profiles and resistance trends is crucial for guiding empirical therapy and mitigating bloodstream infection–related mortality.

Reference

Tsegaye E, Shiferaw D, Tazu Z, Assefa A, Legesse T, Bitew A. Bacterial and fungal profiles, drug resistance patterns and associated factors of isolates recovered from blood samples of patients referred to the Ethiopian Public Health Institute: A cross-sectional study. Abstract CPHM-P-201. Presented at ASM Microbe 2025. June 19–23, 2025. Los Angeles, CA.