Laure Ngando^{1, 2,}, Leopold Mbous Nguimbus^{3, 4}, Massongo Massongo¹, Marie Chantal Ngonde Essome⁵, Albert Legrand Same Ekobo¹

Background: Bloodstream infections (BSIs) are the leading cause of mortality and morbidity worldwide. The aim of this study was to determine the prevalence of germs isolated from blood culture bottles, to see if age and sex are a risk factor for infection, and to present sensitivity and resistance profiles of the germs most represented during the study period. Methods: This was a retrospective and observational study. It carried out in Yaounde, at the Centre Pasteur of Cameroon from January 2010 to December 2019. Samples from patients with a clinical picture of a bloodstream infection were contained in the Bact/Alert FA, FN, and PF Plus bottles and incubated in the Bact/Alert 3D automaton. Antimicrobial susceptibility testing was performed immediately for positive cultures using the diffusion method and the Vitek 2-Compact device. Results: A total of 5687 samples were analyzed during the study period for a prevalence of contaminated samples of 95.4%. The male sex was the most represented with 3011 samples (55.5%) and 2336 samples (43.1%) for the female sex. The mean age of infected patients was 15 years ± 19.1 standard deviation (SD) with the <20 years who were most infected. The distribution differences by sex and age group were statistically significant (p<0.0001). Among the germs isolated from blood culture bottles, the most represented were: Staphylococcus sp. (13.3%), Klebsiella pneumoniae (11.9%), Micrococcus sp. (6.3%), Staphylococcus epidermidis (6.2%), Staphylococcus aureus (5.3%), Staphylococcus haemolyticus (4.7%), Escherichia coli (4.6%), Enterobacter cloacae (4.2%) and Acinetobacter baumannii (4.0%), Staphylococcus hominis (3.6%). This study showed that a statistically significant association exists between the isolated organisms and age groups (p<0.0001). Antimicrobial susceptibility testing showed that Enterobacter cloacae, Enterococcus faecium, Klebsiella oxytoca, Klebsiella pneumoniae, Serratia marcescens, Staphylococcus aureus and Staphylococcus epidermidis were the most resistances in the antibiotics of penicillin family. In the cephalosporin family, the most important resistances were observed for Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae and Serratia marcescens. As for sulfamides, the bacterial species most resistant to cotrimoxazole were Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Salmonella typhimurium. Concerning yeasts, Candida sp. and Candida parapsilosis were the most represented with higher resistances for amphotericin B. Conclusion: The results of this research with the high prevalence of a bloodstream infections and the high rates of antibiotic resistance show the need to expand the surveillance of multidrug resistance in all regions of the country and to initiate research aimed at understanding the genetic mechanisms involved in the increase of resistance.

bloodstream infections, antimicrobial susceptibility testing, Vitek 2-compact, multidrug resistance