Commonly Isolated Bacteria from Sterile Body Fluid Samples and their Antibiotic Sensitivity Pattern in Belize

A Retrospective Pilot Study

Abstract

In developing countries like Belize, antimicrobial resistance presents unique public health challenges driven by limited surveillance resources, substandard or falsified antibiotics, inadequate testing facilities, indiscriminate human and agricultural antibiotic use, and weak policy enforcement. Multidrug-resistant bacterial pathogens pose a severe global threat, making the rapid identification of pathogens in sterile body fluids (SBF) essential for effective clinical management. To our knowledge, this study is the first of its kind in Belize to evaluate bacterial isolates and antimicrobial susceptibility patterns in SBF. Retrospective records from the Belize Central Medical Lab spanning August 2018 to July 2020 were analyzed. Positive cultures and antimicrobial susceptibility testing were performed using the Kirby-Bauer disk diffusion method in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Coagulase-negative staphylococci were the most prevalent isolate (23%), likely representing skin contaminants, followed by Pseudomonas aeruginosa (15.5%). For gram-positive isolates, vancomycin demonstrated 100% susceptibility, whereas ampicillin and erythromycin showed low sensitivity rates of 16% and 32%, respectively. Gram-negative isolates exhibited high sensitivity to imipenem (94.5%) and amikacin (91%), but notable resistance to ciprofloxacin (24.3%). Additionally, pronounced resistance to gentamicin was observed across both gram-positive (31.7%) and gram-negative (35.4%) isolates. These findings provide essential baseline data to assist healthcare professionals in selecting appropriate empirical antibiotic therapies for bacterial infections in Belize. Ultimately, this work supports the design and implementation of larger-scale research aimed at strengthening national public health surveillance and policy enforcement strategies.