Blood culture positivity rate and associated factors among hospitalized adult medical patients at University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia, 2023

Abstract

Introduction: Bloodstream infections (BSI) are the presence of circulating microorganisms in the blood which are detected by positive blood culture (BC). Bacteria, which can be acquired in the community as well as in the hospital, are the principal microorganisms implicated. Although blood culture is a highly sensitive and specific test for detecting BSIs, a wide range of BC positivity rate and a number of factors that affect BC results were reported. Objectives: This study was designed to assess blood culture positivity rate and associated factors among hospitalized adult medical patients at University of Gondar comprehensive specialized Hospital (UOGCSH), 2023 Methods: A single centered hospital based cross-sectional study was conducted among hospitalized adult medical patients at UOGCSH from August 2023 to December 2023. The collected data were coded and entered into EpiData version 4.6 and then transferred to SPSS version 27 for analysis. Both descriptive and inferential statistics were used for analysis. Variables having p value of <0.2 on binary logistic regression were included in the multivariate analysis. Results: During the study period from a total of 263 BCs, 228 were included in the analysis. The mean age of study participants was 41 (±18) and male to female ratio represents 1.26. Overall BC positivity rate was 18% (41/220). CoNS were the most commonly detected bacteria (n= 27; 11.8%), of which only was considered as clinically significant. True positive pathogens detected in 6.6% (15/228) of BCs. K. pneumoniae (n=4; 26.7%) followed by E. coli and NLFGNRs (each n=3; 20%) were the commonly detected etiologies of BSI. Collected blood volume ≥16 ml (p= 0.018), stroke (p= 0.027), and NLCR (p= 0.043) had shown statistically significant associations with true positive BC results. Not using skin antiseptics during venipuncture (p= 0.013) and febrile episodes >38.5oC (p= 0.011) were factors associated with BC yield of contaminants. Conclusion: Although the overall and true BC positivity rates are comparable to most other studies there is a much higher rate of contamination. This could be a reflection of inappropriate blood sample collection techniques. High index of suspicion for BSIs should be there for patients with NLCR ≥12 and those having stroke