Bacterial profile, antimicrobial susceptibility Patterns and associated factors among septicemia Suspected patients in intensive care unit at jimma University comprehensive specialized hospital, south West Ethiopia

Abstract

Background: Septicemia is a leading cause of intensive care units (ICUs), morbidity and mortality, which is a life-threatening organ dysfunction driven by dysregulated host response to infection and antimicrobial resistance (AMR). In Ethiopia data related to causative agents, resistance pattern and risk factor of septicemia is very scarce. This study aimed to determine the bacterial profile, antimicrobial susceptibility patterns, and associated factors among septicemia suspected ICU patients at Jimma University Comprehensive Specialized Hospital (JUCSH). Methods: A cross- sectional study was conducted at JUCSH, from October 9, 2023 to October 8, 2024. Blood culture was performed for a total of 150 septicemia suspected patients at ICU wards. Bacterial isolation and identification were made using standard bacteriological methods. Antimicrobial susceptibility was done by disk diffusion method. Extended spectrum beta lactamase (ESBL) and carbapenemase (CP) production were determined among gram negative bacilli (GNB). Socio-demographic, risk factors and clinical data were collected using structured questionaries prepared for this purpose and parameters were entered and analyzed using SPSS version 26. The variables were assessed using bivariate and multivariate logistic regression and adjusted odds ratio with 95% CI, ≤0.05 was considered statistically significant. Results: Of 150 participants, 22% (33/150) of them had a positive blood culture. GNB accounted for 75.7% (25/33), with 44% (11/25), and 48% (12/25) cases involving ESBL and CP producing strains, while Gram-positive bacteria were 24.2% (8/33) respectively. E. coli 18.2% (6/33) and S. aures 15.2% (5/33) were the predominant isolates. Overall, 63.6% of isolates were multi-drug resistant (MDR). Previous hospitalization (AOR: 9.42, 95%CI=2.12-41.77, p<0.003) and prior antibiotic use (AOR: 0.08, 95%CI=0.01-0.68, p<0.02) were strongly associated with septicemia. Conclusion: The prevalence rate of septicemia suspected patients was significantly high. GNB were the predominant isolates and majority of isolates were MDR pathogens. Recommendations: Better diagnostic capability, enhanced infection prevention and antibiotic stewardship programs (ASP) is necessary to reduce the incidence of septicemia and AMR.