Bloodstream Infections and Antimicrobial Resistance in The Gambia: Continuous Surveillance from a Tertiary Care Center.

Antimicrobial resistance (AMR) poses a major threat to global health, with limited surveillance data available from western sub-Saharan Africa. After reports of high rates of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) in bloodstream infections at The Gambia's sole tertiary hospital, we present follow-up data after enhancements in microbiology capacity. This study included 1,010 patients with blood cultures taken at Edward Francis Small Teaching Hospital between September 2023 and August 2024. The positivity rate remained high (31%), particularly among neonates and critically ill patients. Staphylococcus aureus was the most frequently isolated pathogen (49%, n = 155/314), with MRSA identified in 22% (n = 34/152) of tested isolates. Among Enterobacterales, ESBL production remained high (87%, n = 84/97), and carbapenem resistance was detected in 15% (n = 6/39) of tested isolates. Our findings highlight the need for a robust and sustained AMR surveillance system to inform targeted interventions aimed at reducing the emergence and spread of multidrug-resistant pathogens.