Bloodstream Infections at a West Bank Hospital Show High Antibiotic Resistance

Patients admitted to Jenin Governmental Hospital in the north of the West Bank face a substantial burden of bloodstream infections, and the bacteria responsible are frequently resistant to commonly used antibiotics, according to a retrospective observational study published in BMC Infectious Diseases. Researchers analyzed 1,495 blood cultures drawn from 1,190 patients across the hospital’s wards over a four-month period from October 2022 to February 2023, and found that 152 cultures, or 10.2 percent, tested positive for pathogens.

The incidence figures varied sharply by care setting. Among inpatients, the researchers calculated 13.9 bloodstream infections per 1,000 patient-days, with a 95 percent confidence interval of 11.65 to 16.15. Among outpatients, the rate was 3.7 infections per 1,000 patient visits, with a much wider confidence interval of 0.7 to 6.7, reflecting the smaller number of positive cultures in that group. The two denominators distinguish the risk carried by a day of hospitalization from the risk attached to an outpatient encounter.

The origin of the infections split unevenly between the community and the hospital itself. Of the 152 bloodstream infection cases, 61, or 40.1 percent, were classified as community-acquired, while 91, or 59.9 percent, were hospital-acquired. The study’s background notes that bloodstream infections lead to serious complications, an increased length of hospital stay, and a higher mortality rate, which frames the concern raised by the majority of cases acquired within the hospital.

The bacteriological profile was dominated by Gram-negative organisms, which accounted for 55.9 percent of positive results, while Gram-positive bacteria made up 43.4 percent. Among the Gram-negative pathogens, Klebsiella species were the most frequently detected, representing 19.1 percent of all identified pathogens, followed by Escherichia coli at 11.2 percent and Pseudomonas species at 9.2 percent. Among Gram-positive bacteria, Staphylococcus aureus was the predominant isolate, accounting for 32.2 percent.

Age shaped the distribution of infection risk in this cohort. The highest infection rate occurred among patients aged 40 to 59 years, at 16.0 percent with a 95 percent confidence interval of 11.1 to 22.6 percent. That figure was significantly higher than the rate among infants younger than one month, which stood at 5.1 percent with a confidence interval of 3.3 to 7.9 percent, with a P value below 0.001.

Clinical and treatment variables also showed measurable associations with bloodstream infection. Dialysis was significantly associated with the development of these infections, with a P value below 0.001. Among symptoms, chills were significantly associated with bloodstream infection, with a P value of 0.047. The study also collected data on chronic diseases, inflammatory markers, signs and symptoms, and antibiotic use, though the abstract reports significant associations only for dialysis and chills.

The resistance data form the study’s most urgent message. Among Gram-positive bacteria, resistance was highest against erythromycin at 70.0 percent, with a 95 percent confidence interval of 57.3 to 80.5 percent, and against co-trimoxazole at 55.0 percent, with a confidence interval of 39.8 to 69.3 percent. Among Gram-negative bacteria, resistance reached 74.0 percent for the amoxicillin-clavulanic acid combination, with a confidence interval of 61.1 to 83.8 percent, and 62.0 percent for cefuroxime, with a confidence interval of 47.6 to 74.9 percent.

The authors conclude from these findings that an antibiotic stewardship program must be developed at the hospital, citing the high rate of detection of multidrug-resistant bacteria as the driving reason. The study also reports that bloodstream infections were associated with increased mortality and prolonged hospital stay among the patients affected.

As a retrospective observational study conducted at a single governmental hospital over four months, the work describes patterns within one institution and one time period rather than establishing causal effects or generalizable national rates. The confidence intervals around several estimates, particularly the outpatient incidence, are wide, and the observational design means the reported associations, including those with dialysis and chills, reflect correlations within this cohort. Even with those limits, the combination of a substantial infection incidence, a majority of hospital-acquired cases, and resistance to multiple antibiotics marks this dataset as a concrete signal for infection control planning at the hospital.

Subject of Research: Incidence, bacteriological profile, and antibiotic resistance of bloodstream infections at Jenin Governmental Hospital

Article Title: Incidence and bacteriological profile of bloodstream infections among patients admitted to Jenin governmental hospital: a retrospective observational study

Article References: Alhag, S. A. Y., & Al-Masri, M. Y. (2026). Incidence and bacteriological profile of bloodstream infections among patients admitted to Jenin governmental hospital: a retrospective observational study. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14675-8

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14675-8

Keywords: bloodstream infections, antibiotic resistance, Jenin Governmental Hospital, Klebsiella, Staphylococcus aureus, Gram-negative bacteria, hospital-acquired infection, antibiotic stewardship, West Bank, retrospective study, Incidence, bacteriological