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Background  Physicians depend on reliable information on the local epidemiology of infection and antibiotic resistance rates to guide empiric treatment in critically ill patients. As these data are scarce for Central Africa, we performed a retrospective analysis of microbiological findings from a secondary care hospital in Gabon.    Methods  Microbiological reports from 2009 to 2012 were used to assess the non-susceptibility rates of the three most common isolates from six major types of infections (bloodstream, ear-eye-nose-throat, surgical site, skin and soft tissue, urinary tract and wound infection).    Results  A high diversity of pathogens was found, but  Staphylococcus aureus  was predominant in the majority of infections. Overall, the three most prevalent pathogens in children were  S. aureus  (33.7%),  Streptococcus pyogenes  (8.1%) and  Escherichia coli  (4.5%) and in adults  S. aureus  (23.5%),  E. coli  (15.1%) and  Klebsiella pneumoniae  (7.4%). In total, 5.8% (n = 19) of all  S. aureus  isolates were methicillin resistant. The proportion of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae was 15.4% (n = 78), 49.4% of all  K. pneumoniae  were ESBL-producer (n = 42).    Conclusion  The high diversity of potential pathogens and high resistance rates in Gram-negative bacteria challenge a rational empiric use of antibiotics. Countrywide continuous sentinel surveillance is therefore urgently needed.

Retrospective analysis of antimicrobial resistance and bacterial spectrum of infection in Gabon, Central Africa