Published in PLOS One on 2026-07-27, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Michael Getie, Wudu Tafere, Alem Tsega, Tsehaynesh Gebreyesus, Gizeaddis Belay, Hailu Getachew, Yosef Gashaw, Aimro Tadese, Tigist Birku, Tigabu Birhan, Alemayehu Abate, Teshiwal Deress, Gebremedhin Necho, Belay Bezabih, Mengistu Zenebe
Source: PLOS One • DOI 10.1371/journal.pone.0354710
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Managing bloodstream infections in resource-constrained regions like Ethiopia is challenging due to scarce blood culture surveillance data. To guide empirical therapy, this study determines the bacterial profiles and antimicrobial resistance patterns among patients with suspected bloodstream infections at the Amhara Public Health Institute.
This retrospective study analyzed blood culture records from the Amhara Public Health Institute spanning January 1, 2020, to December 30, 2023. Blood samples were processed using standardized manual culture techniques in accordance with World Health Organization (WHO) protocols. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analysis was conducted using SPSS version 20, employing descriptive statistics and regression models, with statistical significance defined as p < 0.05.
True bacterial pathogens were isolated from 50.3% (N = 340) of the 676 patients, with Gram-negative bacteria predominating (61.2%, N = 208) over Gram-positive bacteria (38.8%, N = 132). Notably, ESKAPEE pathogens accounted for 96.5% (N = 328) of all isolates, led by Klebsiella spp. (25.9%, N = 88), Enterococcus spp. (20.9%, N = 71), and S. aureus (15.6%, N = 53). Among Gram-positive isolates, high resistance was observed against oxacillin (74.5%, N = 41), penicillin (72%, N = 36), and vancomycin (51.1%, N = 24). Gram-negative isolates exhibited critical resistance to national frontline therapeutics, including ampicillin (100%, N = 24), ceftriaxone (92.4%, N = 157), and trimethoprim-sulfamethoxazole (89.4%, N = 126). Overall, multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) profiles were detected in 43.8% (N = 149), 30.5% (N = 104) and 5.3% (N = 18) of isolates with similar distributions observed among ESKAPEE strains. Sex and age were the only independent predictors of culture positivity, with female sex reducing bloodstream infection odds by 44% (p = 0.002). Conversely, neonates (≤ 28 days) and young adults (15–24 years) had 4.7 times (p = 0.001) and 9.5-times (p = 0.001) higher odds compared to elderly patients.
This study reveals a severe 50.3% (N = 340) bloodstream infection rate dominated by highly resistant Gram-negative and ESKAPEE pathogens, disproportionately affecting males, neonates, and young adults. Combating this threat requires immediate antibiotic stewardship, updated guidelines, and advanced laboratory testing (anaerobic culture, minimum inhibitory concentration, and molecular sequencing) to track and manage resistance.
Background
Bloodstream infections (BSIs) are severe, life-threatening conditions primarily caused by bacteria, fungi, viruses, and protozoa can also invade the bloodstream [1]. Globally, they are associated with high morbidity, prolonged hospital stays, increased intensive care needs, and significant mortality rates ranging from 20% to 50%. In 2020, the World Health Organization (WHO) reported that sepsis a common complication of BSIs affects 49 million people and causes 11 million deaths annually, disproportionately affecting children [2,3]. Symptoms range from fever, chills, and altered mental status to severe complications like septic shock and multi-organ failure.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Michael Getie, Wudu Tafere, Alem Tsega, Tsehaynesh Gebreyesus, Gizeaddis Belay, Hailu Getachew, Yosef Gashaw, Aimro Tadese, Tigist Birku, Tigabu Birhan, Alemayehu Abate, Teshiwal Deress, Gebremedhin Necho, Belay Bezabih, Mengistu Zenebe. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Bacteriological profiles, antimicrobial resistance patterns, and predictors of culture-confirmed neonatal Sepsis at Asella Teaching Hospital, Southeast Ethiopia
- Evidence brief: Bacterial isolates and antimicrobial susceptibility profiles of pediatric meningitis at comprehensive specialized hospitals in Bahir Dar, Northwest Ethiopia
- Evidence brief: Sepsis neonatorum: Bacterial profile, antimicrobial resistance patterns, among neonates and associated factors, Dilla University Referral Hospital, southern Ethiopia, with special reference to WHO prioritized pathogens
