Diversity, Distribution, and Resistance Profiles of Bacterial Bloodstream Infections in Three Tertiary Referral Hospitals in Rwanda Between 2020 and 2022.

: The burden of bacterial bloodstream infections (BSIs) is rapidly increasing in Africa including Rwanda. : This is a retrospective study that investigates the diversity, distribution, and antimicrobial susceptibility profiles of BSI bacteria in three tertiary referral hospitals in Rwanda between 2020 and 2022. : A total of 1532 blood culture tests were performed for visiting patients. Overall, the proportions of Gram-negative and Gram-positive bacteria were 48.2% and 51.8, respectively. was the predominant species accounting for 25% of all Gram-positive BSI species, and Klebsiella species represented 41% of all Gram-negative BSI species. Antimicrobial susceptibility testing revealed that Amikacin exhibited the highest activity against spp., spp., and in >92% of cases and spp. in 75.7%. Meropenem and Imipenem were highly efficacious to spp. (100% susceptibility), spp. (96.2% and 91.7%, respectively), and (94.7% and 95.5%, respectively). The susceptibility of spp., , and spp. to Vancomycin was 100%, 99.5%, and 97.1%, respectively. spp. was highly sensitive to Colistin (98.7%), Polymyxin B (85.6%), Imipenem (84.9%), and Meropenem (78.5%). : We recommend strengthening the implementation of integrated transdisciplinary and multisectoral One Health including AMR stewardship for the surveillance, prevention, and control of AMR in Rwanda.