Blood culture testing outcomes among non-malarial febrile children at antimicrobial resistance surveillance sites in Uganda, 2017-2018

Rogers Kisame, Robinah Najjemba, Johan van Griensven, Freddy Eric Kitutu, Kudakwashe Takarinda, Pruthu Thekkur, Alexandre Delamou, Richard Walwema, Francis Kakooza, Ibrahim Mugerwa, Musa Sekamatte, Kimera Robert, Thomas Katairo, Marc Sam Opollo, Morgan Otita, Mohammed Lamorde

Research output: Contribution to journalA2: International peer reviewed article (not A1-type)

Abstract

Blood culture (BC) processes are critical to the utility of diagnostic testing, bloodstream infection (BSI) management, and antimicrobial resistance (AMR) surveillance. While Uganda has established BC guidelines, often laboratory practice does not meet the desired standards. This compromises pathogen recovery, reliability of antimicrobial susceptibility testing, and diagnostic test utility. This study assessed laboratory BC process outcomes among non-malarial febrile children below five years of age at five AMR surveillance sites in Uganda between 2017 and 2018. Secondary BC testing data was reviewed against established standards. Overall, 959 BC specimens were processed. Of these, 91% were from female patients, neonates, infants, and young children (1-48 months). A total of 37 AMR priority pathogens were identified; Staphylococcus aureus was predominant (54%), followed by Escherichia coli (19%). The diagnostic yield was low (4.9%). Only 6.3% of isolates were identified. AST was performed on 70% (18/26) of identified AMR priority isolates, and only 40% of these tests adhered to recommended standards. Interventions are needed to improve laboratory BC practices for effective patient management through targeted antimicrobial therapy and AMR surveillance in Uganda. Further research on process documentation, diagnostic yield, and a review of patient outcomes for all hospitalized febrile patients is needed.

Original languageEnglish
JournalTropical Medicine and Infectious Disease
Volume6
Issue number2
ISSN2414-6366
DOIs
Publication statusPublished - 2021

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