Kassu DestaSenay Getahun2025-08-122025-08-122024-02-13https://etd.aau.edu.et/handle/123456789/6517Background: Sterile body fluid infection requires rapid and accurate diagnosis and treatment because its morbidity and mortality are high. Continuous laboratory surveillance is important to guide clinicians in providing effective preventive and evidence-based therapies to achieve this goal. Objectives: The study aimed to determine bacterial isolates and antibiotic susceptibility patterns from sterile body fluids at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A hospital-based cross-sectional study was conducted from May 1 to December 30, 2023, among 205 randomly selected patients. Data were collected through interviews using a pretested questionnaire. Sterile body fluids submitted to the laboratory were processed according to standard laboratory procedures. Antimicrobial susceptibility testing was performed using the Kirby Bauer disc diffusion method according to CLSI guidelines. ESBL & CRE detection were made using cephalosporin/ clavulanate combination discs & modified Hodge test, respectively. Data entry and analysis were performed using SPSS v26. Bivariate and multivariate logistic regressions were used to assess the association between the outcome and predictor variables. Result: Approximately one-fifth (19.5%, n=40) of the processed samples were culture-positive. Most of the pathogens detected were gram-negative bacteria (GNB), 72.5%, while gram-positive bacteria accounted for 27.5%. Gram-negative isolates were 86.2% sensitive to amikacin & meropenem (76%), while gram-positive isolates were sensitive to ciprofloxacin (72.7%). Among GNB, 68.2% were extended-spectrum beta-lactamase producers, while 36.4% were carbapenemase producers. MDR, mostly associated with penicillins and third-generation cephalosporins, was detected in 67.5% of the isolates. Culture positivity was associated with rural residence (AOR: 3.86, 95% CI: 1.58-9.42, P = 0.003), inpatient status (AOR: 2.65, 95% CI: 1.17 5.99, P = 0.019), comorbidities (AOR: 5.46, 95% CI: 2.22-13.40, P = 0.001) and turbid appearance (AOR: 3.37, 95% CI: 1.17-9.70, P = 0.024). Conclusion: In this study, significant drug resistance to commonly prescribed beta-lactam antibiotics and a high MDR were observed, necessitating the use of prudent antibiotics in hospital and community settings by all healthcare workers and policymakers. Keywords: sterile body fluid infection, antimicrobial resistance, extended-spectrum beta lactamase, antibiotic stewardship, Tikur Anbessa, Ethiopiaen-USsterile body fluid infection antimicrobial resistanceextended-spectrum beta-lactamaseantibiotic stewardshipTikur AnbessaEthiopiaThesis