ArticleBMC microbiology2026
Mortality outcomes and economic burden of antimicrobial-resistant bacterial bloodstream infections in a Nigerian tertiary hospital.
Article in BMC microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAntimicrobial resistance (AMR) poses a global public health and economic challenge, significantly contributing to poor outcomes of bacteria bloodstream infections (BSI). There is a paucity of local data on outcomes of AMR BSIs in Nigeria. This prospective cohort study determined outcomes and healthcare costs of BSIs stratified by resistance status.
methodData were prospectively collected from enrolled participants (neonates, children and adults) with susceptible (cohort 1) and resistant (cohort 2) BSIs caused by Enterobacterales, Pseudomonas spp, Acinetobacter spp., Staphylococcus aureus, and Enterococcus spp, and a control group without BSI (cohort 3), at the University of Port Harcourt Teaching Hospital between April and November 2025. Outcomes (in-hospital mortality and extra length of hospital stay, LOS) were compared between the three cohorts using time-dependent and multi-state regression models that adjusted for patients' characteristics, time-varying cofounders and competing risks, while healthcare costs were compared using Students' t' test and analysis of variance.
resultsA total of 952 patients were recruited, with 330 neonates, 271 children and 351 adults. The overall prevalence of bacteria-confirmed BSI was 18.1%, with neonatal BSI of 27.3%, childhood BSI of 12.5% and adult BSI of 13.7% (p < 0.0001). In-hospital mortality was higher for healthcare onset (HO) compared to community onset (CO) BSI (
conclusionCompared to susceptible bacterial BSIs, resistant bacterial BSIs are associated with higher mortality, extra length of hospital stays and excess healthcare costs. Policies to reduce the burden of resistant BSIs should focus on improving infection prevention and control and antimicrobial stewardship practices in both hospital settings and the community.
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