Evidence map›Paper›PMID 39984936›Full record

ArticleAnnals of clinical microbiology and antimicrobials2025

Major blood stream infection-causing bacterial pathogens, antimicrobial resistance patterns and trends: a multisite retrospective study in Asmara, Eritrea (2014-2022).

Yosan Gebremeskel Andemichael, Eyorusalem Tsehaye Habtetsion, Hagos Hayelom Gulbet, Maedn Hailemariam Eman, Oliver Okoth Achila, Samuel Tekle Mengistu, Azania Werede Andemichael, Abrehet Marikos Buthuamlak, Eyob Yohannes Garoy, Berhe Tesfai and 1 more

Abstract readMulticenter Study
In one paragraph

Article in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yosan Gebremeskel AndemichaelMicrobiology Department, National Health Laboratory, Ministry of Health, Asmara, Eritrea.
Eyorusalem Tsehaye HabtetsionMicrobiology Department, National Health Laboratory, Ministry of Health, Asmara, Eritrea.
Hagos Hayelom GulbetMicrobiology Department, National Health Laboratory, Ministry of Health, Asmara, Eritrea.
Maedn Hailemariam EmanNational Blood Transfusion Center, Asmara, Eritrea.
Oliver Okoth AchilaUnit of Clinical Laboratory Science, Orotta College of Medicine and Health Science (OCMHS), Asmara, Eritrea.
Samuel Tekle MengistuNorthern Red Sea Ministry of health branch, Nakfa Hospital, Asmara, Eritrea.ORCID http://orcid.org/0000-0002-2817-1421
Azania Werede AndemichaelNational Medicines and Food Administration, Ministry of Health, Asmara, Eritrea.ORCID http://orcid.org/0000-0002-5689-5945
Abrehet Marikos ButhuamlakNational Blood Transfusion Center, Asmara, Eritrea.
Eyob Yohannes GaroyUnit of Clinical Laboratory Science, Orotta College of Medicine and Health Science (OCMHS), Asmara, Eritrea.
Berhe TesfaiDepartment of Obstetrics and Gynecology, Orotta College of Medicine and Health Sciences, Orotta National Referral Maternity Hospital, Ministry of Health, Asmara, Eritrea.
Mohammed Elfatih HamidaDepartment of Medical Microbiology, Orotta College of Medicine and Health Sciences, Asmara, Eritrea. mohelfatih77@gmail.com.ORCID http://orcid.org/0000-0002-5337-399X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAn important knowledge gap exists on the epidemiology of blood stream infections (BSIs) in low-middle-income countries (LMICs). In this retrospective analysis, we evaluated the etiology, antimicrobial resistance (AMR) and trends of BSIs in Eritrea.

methodsThe study reviewed 9-year records (January 2014- December 2022) of 3153 patients with blood culture results available in the National Health Laboratory (NHL) archives. Relevant data included age, sex, hospital/care center, and year.

resultDuring the surveillance period, we examined data from 3153 patients (1797 (57.0%) men vs. 1356 (43.0%) females, and 1.2 years (Q1: 0.01 months - Q3: 15 years). Of the samples submitted, 1026 (35.5%) samples were positive for the presence of pathogens (663(64.6%) pathogens vs. 363 (35.4%)) potential contaminants. In decreasing frequency, the most common isolates were: Coagulase-negative Staphylococcus (CoNs), 189 (28.6%); Klebsiella spp., 120 (18.2%); Escherichia coli, 66 (10.0%); Citrobacter spp., 48 (7.3%); Staphylococcus aureus, 47(7.1%); Pseudomonas aeruginosa, 34 (5.1%); and Salmonella spp., 33(5.1). The relative prevalence of BSIs changed somewhat over time (p-value < 0.001) with the isolation of multiple isolates trending upward from 2018 and onwards. Additional findings included the likely presence of extended spectrum beta lactamase (ESBL), high frequency of methicillin resistant Staphylococcus aureus (MRSA) (37(80.4%) and high rate of resistance to gentamicin (363(62.5%) and fluoroquinolones. Furthermore, the multiple antimicrobial resistances (MAR) index was relatively high (mean = 0.55, SD: ±0.23) with wide species-level variation. In a related density cluster analysis, we demonstrated a time-dependent increase in the diversity of resistotypes.

conclusionThis study highlights the considerable health burden of AMR/or MDR in BSIs in Eritrea. Additionally, it underscores the urgent need for enhanced laboratory capacity, surveillance, institutionalisation of antibiotic stewardship programs, and robust infection control programs in hospitals across the country. The need for multidisciplinary research was also highlighted.

Indexed as

Anti-Bacterial AgentsBacteremiaBacteriaDrug Resistance, BacterialAdolescentAdultAgedChildChild, PreschoolEritreaFemaleHumansInfantMaleMicrobial Sensitivity TestsMiddle AgedAnti-Bacterial AgentsAnd AfricaBacteraemiaBlood stream infectionsEritreaMRSAMultidrug resistanceSepsis

Identifiers

PMID39984936
PMCPMC11846260

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.