Use and Quality of Blood Cultures for the Diagnosis of Blood-stream Infections: A Cross-sectional Study in the Ho Teaching Hospital, Ghana; 2019-2021.

Bloodstream Infections (BSI) are associated with severe morbidity and mortality. Blood Culture and Drug Susceptibility Testing (CDST) remains vital for the diagnosis and management of BSI. Using retrospective routine medical and laboratory records, we described blood culture requests by clinicians and the quality of CDST processes for the diagnosis of BSI among patients admitted to the Ho Teaching Hospital in Ghana from 2019 to 2021. Of 4,278 patients with suspected BSI, only 8% (351/4,278) had blood CDST requested, with the majority of indications being pneumonia (40%) and neonatal sepsis (22%). Of the 94% (329/351) of blood cultures processed and reported, only 7% (22/329) were culture positive, <em>Klebsiella spp.</em> being the most frequently recovered pathogen (4/22). Of the Gram-negative rod isolates, 8/19 exhibited Multi Drug Resistance. The median lead time from admission to blood CDST reporting was 10 days (IQR: 7– 14). Likely contaminants were recovered from 16% of the specimens. Targeted interventions are required to enhance a) the utilisation of blood CDST by clinicians, b) the quality of laboratory processes and c) Antimicrobial Resistance Surveillance.