Antimicrobial resistance of bacteria isolated from blood cultures at a tertiary hospital in Papua New Guinea: implications for antimicrobial stewardship and surveillance

IntroductionBloodstream infection (BSI) is a global healthcare concern, especially in low- and middle-income countries (LMIC) where diagnostic capacity and antimicrobial stewardship programs remain limited. Local data on bacterial causative agents and antimicrobial resistance (AMR) remain scarce in the Pacific Island Countries and Territories, including Papua New Guinea (PNG). This study aimed to determine the prevalence, bacterial spectrum, antimicrobial susceptibility patterns, and distribution of bloodstream pathogens among patients attending Goroka Provincial Hospital in Papua New Guinea.MethodsWe conducted a retrospective laboratory surveillance study using routine blood culture data from Goroka Provincial Hospital. Bacterial identification and antimicrobial susceptibility results were retrieved from Senaite Laboratory Information Management System (LIMS) and analysed using WHONET and SPSS.ResultsA total of 1,276 blood culture specimens were collected from patients with clinically suspected BSI, of which 141 (11.1%) yielded bacterial pathogens. Salmonella enterica servovar Typhi (S. Typhi) was the predominant isolate (72/141, 51.1%), followed by Staphylococcus aureus (S. aureus) (23/141, 16.3%). Most S. Typhi isolates were susceptible to first line antibiotics tested (98–100%), however, 45% were resistant to chloramphenicol. Methicillin-resistant S. aureus (MRSA) accounted for 60.9% of S. aureus isolates. Extended-spectrumβ-lactamase (ESBL)-positive Escherichia coli and Klebsiella pneumoniae were susceptible to meropenem, piperacillin-tazobactam, and amikacin.ConclusionSalmonella Typhi was the predominant cause of BSI and showed substantial chloramphenicol resistance, while phenotypically ESBL-positive bacteria were also detected. These findings underscore the need for continued laboratory-based AMR surveillance and locally informed antimicrobial stewardship and infection-prevention strategies in PNG.