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Darkwah S, Kotey FCN, Ahenkorah J, Adutwum-Ofosu KK, Donkor ES. Sepsis-Related Lung Injury and the Complication of Extrapulmonary Pneumococcal Pneumonia. Diseases 2024; 12:72. [PMID: 38667530 PMCID: PMC11049144 DOI: 10.3390/diseases12040072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/18/2023] [Accepted: 11/26/2023] [Indexed: 04/28/2024] Open
Abstract
Globally, sepsis and pneumonia account for significant mortality and morbidity. A complex interplay of immune-molecular pathways underlies both sepsis and pneumonia, resulting in similar and overlapping disease characteristics. Sepsis could result from unmanaged pneumonia. Similarly, sepsis patients have pneumonia as a common complication in the intensive care unit. A significant percentage of pneumonia is misdiagnosed as septic shock. Therefore, our knowledge of the clinical relationship between pneumonia and sepsis is imperative to the proper management of these syndromes. Regarding pathogenesis and etiology, pneumococcus is one of the leading pathogens implicated in both pneumonia and sepsis syndromes. Growing evidence suggests that pneumococcal pneumonia can potentially disseminate and consequently induce systemic inflammation and severe sepsis. Streptococcus pneumoniae could potentially exploit the function of dendritic cells (DCs) to facilitate bacterial dissemination. This highlights the importance of pathogen-immune cell crosstalk in the pathophysiology of sepsis and pneumonia. The role of DCs in pneumococcal infections and sepsis is not well understood. Therefore, studying the immunologic crosstalk between pneumococcus and host immune mediators is crucial to elucidating the pathophysiology of pneumonia-induced lung injury and sepsis. This knowledge would help mitigate clinical diagnosis and management challenges.
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Affiliation(s)
- Samuel Darkwah
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (F.C.N.K.); (E.S.D.)
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (F.C.N.K.); (E.S.D.)
| | - John Ahenkorah
- Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (J.A.); (K.K.A.-O.)
| | - Kevin Kofi Adutwum-Ofosu
- Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (J.A.); (K.K.A.-O.)
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (F.C.N.K.); (E.S.D.)
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Osman AH, Kotey FCN, Odoom A, Darkwah S, Yeboah RK, Dayie NTKD, Donkor ES. The Potential of Bacteriophage-Antibiotic Combination Therapy in Treating Infections with Multidrug-Resistant Bacteria. Antibiotics (Basel) 2023; 12:1329. [PMID: 37627749 PMCID: PMC10451467 DOI: 10.3390/antibiotics12081329] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/04/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
The growing threat of antibiotic resistance is a significant global health challenge that has intensified in recent years. The burden of antibiotic resistance on public health is augmented due to its multifaceted nature, as well as the slow-paced and limited development of new antibiotics. The threat posed by resistance is now existential in phage therapy, which had long been touted as a promising replacement for antibiotics. Consequently, it is imperative to explore the potential of combination therapies involving antibiotics and phages as a feasible alternative for treating infections with multidrug-resistant bacteria. Although either bacteriophage or antibiotics can potentially treat bacterial infections, they are each fraught with resistance. Combination therapies, however, yielded positive outcomes in most cases; nonetheless, a few combinations did not show any benefit. Combination therapies comprising the synergistic activity of phages and antibiotics and combinations of phages with other treatments such as probiotics hold promise in the treatment of drug-resistant bacterial infections.
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Affiliation(s)
| | | | | | | | | | | | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra P.O. Box KB 4236, Ghana; (A.-H.O.); (F.C.N.K.); (A.O.); (S.D.); (R.K.Y.); (N.T.K.D.D.)
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Sa-eed A, Donkor ES, Arhin RE, Tetteh-Quarcoo PB, Attah SK, Kabotso DEK, Kotey FCN, Dayie NTKD. In vitro antimicrobial activity of crude propolis extracts and fractions. FEMS Microbes 2023; 4:xtad010. [PMID: 37333437 PMCID: PMC10165684 DOI: 10.1093/femsmc/xtad010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 12/16/2022] [Accepted: 04/19/2023] [Indexed: 06/20/2023] Open
Abstract
The search for antimicrobials in propolis presents a new dimension for addressing the problem of antimicrobial drug resistance. The aim of this study was to determine the antimicrobial activity of extracts of crude propolis collected from different regions in Ghana and their active fractions. The antimicrobial activity of the extracts, as well as that of the chloroform, ethyl acetate, and petroleum ether fractions of the active samples were determined using the agar well diffusion method. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of the most active fractions were determined. The various crude propolis extracts frequently produced zones of inhibition against Staphylococcus aureus (17/20) than Pseudomonas aeruginosa (16/20), and Escherichia coli (1/20) test isolates. Chloroform and ethyl acetate solvents produced fractions possessing greater antimicrobial activity than the petroleum ether fraction. The mean MIC range of the most active fractions was greatest for S. aureus (76.0 ± 34.8-48.0 ± 33.0 mg/ml) than for P. aeruginosa (40.8 ± 33.3-30.4 ± 6.7 mg/ml) and E. coli, as was the mean MBC. Propolis has antimicrobial potential, and hence should be exploited as an alternative for the treatment of bacterial infections.
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Affiliation(s)
- Alhassan Sa-eed
- Department of Medical Microbiology, University of Ghana Medical School, P. O. Box KB 4236, Korle Bu, Accra, Ghana
- Department of Medical Laboratory Technology, Accra Technical University, P. O. Box GP 561, Barnes Road, Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, P. O. Box KB 4236, Korle Bu, Accra, Ghana
| | - Reuben E Arhin
- Department of Medical Microbiology, University of Ghana Medical School, P. O. Box KB 4236, Korle Bu, Accra, Ghana
- Department of Science Laboratory Technology, Accra Technical University, P. O. Box GP 561, Barnes Road, Accra, Ghana
| | - Patience B Tetteh-Quarcoo
- Department of Medical Microbiology, University of Ghana Medical School, P. O. Box KB 4236, Korle Bu, Accra, Ghana
| | - Simon K Attah
- Department of Medical Microbiology, University of Ghana Medical School, P. O. Box KB 4236, Korle Bu, Accra, Ghana
- Baldwin University College, P. O. Box 19872, Osu, Accra, Ghana
| | - Daniel E K Kabotso
- Department of Basic Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, Ghana
| | - Fleischer C N Kotey
- Department of Medical Microbiology, University of Ghana Medical School, P. O. Box KB 4236, Korle Bu, Accra, Ghana
- FleRhoLife Research Consult, P.O. Box TS 853, Teshie, Accra, Ghana
| | - Nicholas T K D Dayie
- Corresponding author. Department of Medical Microbiology, University of Ghana Medical School, P. O. Box KB 4236, Korle Bu, Accra, Ghana. Tel: +233 20 886 2855; E-mail:
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Kwansa-Bentum B, Okine BA, Dayie AD, Tetteh-Quarcoo PB, Kotey FCN, Donkor ES, Dayie NTKD. In Vitro effects of petroleum ether, dichloromethane, methanolic and aqueous leaf extracts of Eucalyptus grandis on selected multidrug-resistant bacteria. PLoS One 2023; 18:e0283706. [PMID: 36996141 PMCID: PMC10062571 DOI: 10.1371/journal.pone.0283706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The emergence and spread of antimicrobial resistance is of grave concern, requiring the search for newer and more effective antimicrobials to combat infections caused by resistant microbes. This study assessed the antimicrobial effects of Eucalyptus grandis crude extracts against selected multidrug resistant bacteria. METHODOLOGY Four different crude leaf extracts of E. grandis were prepared using petroleum ether, dichloromethane, methanol, and water, with the aid of the Soxhlet extraction method. These were screened against methicillin-resistant Staphylococcus aureus (MRSA), multidrug resistant Pseudomonas aeruginosa, and multidrug resistant Escherichia coli, using the agar well diffusion method. Phytochemical screening was carried out to evaluate the bioactive phytochemical constituents responsible for the antimicrobial effect. RESULTS Each of the extracts, except for the one prepared from water, had antimicrobial activity against the screened bacteria. The non-polar petroleum ether extract had the highest antimicrobial activity (19.33-24.33 mm), including bactericidal effects, compared to the medium polar dichloromethane and polar methanol extracts, which recorded zone diameter ranges of 14.33-16.67 mm and 16.33-17.67 mm, respectively. The Gram-negative bacteria (E. coli and P. aeruginosa) were the least susceptible in comparison with the Gram-positive bacterium (MRSA), probably owing to differences in their cell wall structures. Furthermore, phytochemical screening indicated the presence of alkaloids, tannins, saponins, terpenoids, and flavonoids. CONCLUSION The findings suggest that E. grandis could be potentially useful in the treatment of infections caused by multidrug resistant bacteria.
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Affiliation(s)
- Bethel Kwansa-Bentum
- Department of Animal Biology and Conservation Science, School of Biological Sciences, University of Ghana, Accra, Ghana
| | - Beatrice Awuradwoa Okine
- Department of Animal Biology and Conservation Science, School of Biological Sciences, University of Ghana, Accra, Ghana
| | - Alberta D Dayie
- Department of Chemistry, University of Cape Coast, Cape Coast, Ghana
| | | | - Fleischer C N Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
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Dwomoh FP, Kotey FCN, Dayie NTKD, Osei MM, Amoa-Owusu F, Bannah V, Alzahrani FM, Halawani IF, Alzahrani KJ, Egyir B, Donkor ES. Phenotypic and genotypic detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in Accra, Ghana. PLoS One 2022; 17:e0279715. [PMID: 36584159 PMCID: PMC9803230 DOI: 10.1371/journal.pone.0279715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/13/2022] [Indexed: 12/31/2022] Open
Abstract
AIM To describe the occurrence of carbapenem resistance among multidrug-resistant (MDR) Escherichia coli and Klebsiella pneumoniae isolated from clinical specimens in Accra using phenotypic and genotypic methods. METHODOLOGY The study was cross-sectional, involving 144 clinical MDR E. coli and K. pneumoniae isolates recovered from the Central Laboratory of the Korle Bu Teaching Hospital (KBTH). The isolates were re-cultured bacteriologically, identified using standard biochemical tests, and subjected to antibiotic susceptibility testing using the Kirby-Bauer method. Carbapenem resistance was determined based on imipenem, meropenem, and ertapenem zones of inhibition, as well as minimum inhibitory concentrations (MICs). Carbapenemase production was determined phenotypically by modified Hodge test (MHT) and modified carbapenem inactivation method (mCIM), and genotypically with multiplex PCR targeting the blaKPC, blaIMP, blaNDM, blaVIM, and blaOXA-48 genes. RESULTS Of the 144 MDR isolates, 69.4% were E. coli, and 30.6% were K. pneumoniae. The distribution of antimicrobial resistance rates among them was ampicillin (97.2%), cefuroxime (93.1%), sulfamethoxazole-trimethoprim (86.8%), tetracycline (85.4%), cefotaxime and cefpodoxime (77.1% each), amoxicillin-clavulanate (75%), ceftriaxone (73.6%), ciprofloxacin (70.8%), levofloxacin (66.0%), cefepime (65.3%), ceftazidime (64.6%), gentamicin (48.6), piperacillin-tazobactam (40.3%), cefoxitin (14.6%), amikacin (13.9%), ertapenem and meropenem (5.6% each), and imipenem (2.8%). In total, 5.6% (8/144) of them were carbapenem-resistant (carbapenem MIC range = 0.094-32.0 μg/ml), with 75% (6/8) of these testing positive by the phenotypic tests and 62.5% (5/8) by the genotypic test (of which 80% [4/5] carried blaOXA-48 and 20% (1/5) blaNDM). The blaVIM, blaIMP, and blaKPC genes were not detected. CONCLUSION Although the rates of antibiotic resistance among the isolates were high, the prevalence of carbapenemase producers was low. The finding of blaOXA-48 and blaNDM warrants upscaling of antimicrobial resistance surveillance programmes and fortification of infection prevention and control programmes in the country.
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Affiliation(s)
- Felicia P. Dwomoh
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
- Department of Medical Laboratory, University of Ghana Medical Centre, Legon, Accra, Ghana
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
- FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
- FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Felicia Amoa-Owusu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Vida Bannah
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Fuad M. Alzahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Ibrahim F. Halawani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Khalid J. Alzahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
- * E-mail: ,
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Tetteh-Quarcoo PB, Afutu E, Wiafe-Ansong M, Kotey FCN, Dayie NTKD, Donkor ES, Ahenkorah J, Udofia EA, Ayeh-Kumi PF, Dzudzor B, Asiedu-Gyekye IJ. Contrasting Hygiene-Related Gastrointestinal Infections and Stress-Related Diseases at a Primary Health Care Facility within a Sub-Saharan African City: Before and during the COVID-19 Pandemic. Diseases 2022; 11:diseases11010002. [PMID: 36648867 PMCID: PMC9844452 DOI: 10.3390/diseases11010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/27/2022] [Accepted: 12/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND With the advent of the COVID-19 pandemic caused by SARS-CoV-2, protocols such as social distancing and upscaling of hygiene practices were implemented to limit the spread of the disease. Meanwhile, along with COVID-19 came stress due to restrictions on movement, trade and transport, and closure of schools, among others. AIM This study compared the prevalence of hygiene-related gastrointestinal infections and stress-related diseases before (March 2019-February 2020) and during (March 2020-February 2021) the COVID-19 pandemic. METHODOLOGY This was a retrospective single-center review of deidentified patient data from the Korle Bu Polyclinic, Accra, Ghana. RESULTS Comparing the pre-COVID-19 era to the COVID-19 era, there was a statistically nonsignificant change in the number of cases and prevalence of gastroenteritis and enteric fever (p = 0.084 and 0.081, respectively), although for gastroenteritis, the prevalence was higher for the pre-COVID-19 era compared to during COVID-19 by 1.8 per 1000 cases, while that of enteric fever was higher during the COVID-19 era compared to the pre-COVID-19 era by 1.0 per 1000 cases. Of the stress-related diseases, statistically significant increases in the prevalence of anxiety disorders (p = 0.028), insomnia (p = 0.001), and headache (p = 0.010), were noted, with 2.3, 5.5, and 2.4 per 1000 cases, respectively. There were more female cases than male cases recorded for depression (p = 0.001), headache (p = 0.010), and hypertension (p = 0.001) during the pandemic, and these were statistically significant. CONCLUSION During the pandemic, a significant increase in the prevalence of stress-related diseases was observed. However, a statistically nonsignificant change was recorded for gastrointestinal infections, with females reporting more of these disorders. Consequently, it is important to strengthen the capacity for managing stress-related conditions alongside diseases that cause pandemics when they arise.
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Affiliation(s)
- Patience B. Tetteh-Quarcoo
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- Correspondence: (P.B.T.-Q.); (E.A.); (B.D.); Tel.: +233-244-202-066 (E.A.)
| | - Emmanuel Afutu
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- Correspondence: (P.B.T.-Q.); (E.A.); (B.D.); Tel.: +233-244-202-066 (E.A.)
| | - Madonna Wiafe-Ansong
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- Department of Community Health, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- FleRhoLife Research Consult, Teshie, Accra P.O. Box TS 853, Ghana
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - John Ahenkorah
- Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Emilia Asuquo Udofia
- Department of Community Health, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Patrick F. Ayeh-Kumi
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Bartholomew Dzudzor
- Department of Medical Biochemistry, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- Correspondence: (P.B.T.-Q.); (E.A.); (B.D.); Tel.: +233-244-202-066 (E.A.)
| | - Isaac Julius Asiedu-Gyekye
- University of Ghana School of Pharmacy, College of Health Sciences, University of Ghana, Accra P.O. Box KB 52, Ghana
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Baah DA, Kotey FCN, Dayie NTKD, Codjoe FS, Tetteh-Quarcoo PB, Donkor ES. Multidrug-Resistant Gram-Negative Bacteria Contaminating Raw Meat Sold in Accra, Ghana. Pathogens 2022; 11:1517. [PMID: 36558851 PMCID: PMC9784824 DOI: 10.3390/pathogens11121517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Efforts to combat antimicrobial resistance (AMR) should be based on the One Health approach, involving human health, animal health, and the environment. In Ghana, previous studies on AMR have given little attention to animal source food, a major route of transmission of antibiotic-resistant zoonotic pathogens. The aim of this study was to investigate the occurrence of multidrug-resistant (MDR) bacteria in meat sold in Accra. METHODS This was a cross-sectional study in which 270 meat samples (90 each of beef, goat meat, and chicken) were collected, and investigated for contamination with multidrug-resistant bacteria. The bacteria were subjected to susceptibility testing against amikacin (30 µg), ampicillin (10 µg), amoxicillin-clavulanate (20/10 µg), cefuroxime (30 µg), ceftriaxone (30 µg), ceftazidime (30 µg), cefepime (30 µg), ciprofloxacin (5 µg), trimethoprim-sulfamethoxazole (1.25/23.75 µg), ertapenem (10 µg), meropenem (10 µg), imipenem (10 µg), tigecycline (15 µg), and gentamicin (10 µg). RESULTS Thirty-two different types of bacteria, totalling 558, were isolated, the predominant being Escherichia coli (44.6%), Aeromonas hydrophila (19.9%), Vibrio cholerae (3.4%), Aeromonas veronii (3.2%), and Klebsiella pneumoniae (3.1%). The prevalence of MDR among the contaminating bacteria was 14.9%. The MDR distribution among the predominant bacteria was Escherichia coli (18.7%), Aeromonas hydrophila (11.1%), Vibrio cholerae and Aeromonas veronii (0.0% each), and K. pneumoniae (5.6%). Moreover, 2.0% of the contaminating bacteria were extended-spectrum beta-lactamase (ESBL) producers, all of which occurred in the chicken samples, and their distribution was: Escherichia coli (1.3%), Klebsiella pneumoniae, Pantoea spp., Enterobacter cloacae, and Serratia plymuthica (0.2% each). CONCLUSIONS The meat samples were heavily contaminated with Escherichia coli and Aeromonas hydrophila, and less frequently, with Vibrio cholerae, Klebsiella pneumoniae, and other organisms. The prevalence of multidrug-resistant bacteria was moderate (14.9%), while that of ESBL producers was low (2%).
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Affiliation(s)
- Deric A. Baah
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
- FleRhoLife Research Consult, Teshie, Accra P.O. Box TS 853, Ghana
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
| | - Francis S. Codjoe
- Department of Medical Laboratory Sciences, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Accra P.O. Box KB 143, Ghana
| | | | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana
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Darkwah S, Agbettor D, Codjoe F, Donkor ES. Microbial Contamination of Herbal Preparations on the Ghanaian
Market, Accra. Microbiol Insights 2022; 15:11786361221139602. [PMCID: PMC9716451 DOI: 10.1177/11786361221139602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/31/2022] [Indexed: 12/05/2022] Open
Abstract
In developing countries, an estimated 80% of the population use traditional
herbal medicines as part of their primary health care. As the market for herbal
medicine expands in many African countries, partly due to their use in the
treatment of COVID-19, there is the need to address all the associated safety
issues. The aim of the study was to evaluate the microbial contamination of
locally prepared, as well as imported foreign herbal products sold in Accra.
Standard microbiological methods were employed in the enumeration of coliforms
and the identification of pathogenic microbes in 60 herbal preparations that
were sampled. A larger proportion (76.7%) of local herbal preparations was
contaminated with bacteria as compared with imported ones (63.3%).
Bacillus species and Pseudomonas
aeruginosa were the predominant bacteria obtained from foreign and
locally manufactured herbal preparations, respectively. A proportion of 36.7%
(11) of the local samples were positive for coliform and the coliform counts
ranged from 3.0 × 101 cfu/ml to 2.0 × 104 cfu/ml. Two
foreign herbal samples (6.7%) were positive for coliforms; one had a count of
1.7 × 105 cfu/g while the other had 2 × 104 cfu/g.
Herbal preparations sold in markets of Accra harbour several microbial
pathogens; the risk is relatively higher for locally produced herbal
preparations compared to imported herbal preparations. As a result, it is
recommended that quality assurance in the production of local herbal
preparations should be thoroughly monitored from the beginning of production to
the final selling of the preparations. There is also the need to strengthen
microbiological safety monitoring of imported herbal preparations.
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Affiliation(s)
- Samuel Darkwah
- Department of Medical Microbiology,
University of Ghana Medical School, University of Ghana, Accra, Ghana,Samuel Darkwah, Department of Medical
Microbiology, University of Ghana Medical School, University of Ghana, P.O. Box
GP4236, C/O P.O. Box CO 1513, Accra, Ghana.
| | - Doris Agbettor
- Department of Medical Laboratory
Sciences, School of Biomedical and Allied Health Sciences, University of Ghana,
Accra, Ghana
| | - Francis Codjoe
- Department of Medical Laboratory
Sciences, School of Biomedical and Allied Health Sciences, University of Ghana,
Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology,
University of Ghana Medical School, University of Ghana, Accra, Ghana
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Addae-Nuku DS, Kotey FCN, Dayie NTKD, Osei MM, Tette EMA, Debrah P, Donkor ES. Multidrug-Resistant Bacteria in Hospital Wastewater of the Korle Bu Teaching Hospital in Accra, Ghana. Environ Health Insights 2022; 16:11786302221130613. [PMID: 36311334 PMCID: PMC9597020 DOI: 10.1177/11786302221130613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 09/15/2022] [Indexed: 06/10/2023]
Abstract
BACKGROUND Antimicrobial resistance (AMR) is one of the top 10 public health threats. One approach to tackling the AMR menace could involve expanding the range of AMR surveillance domains to include hospital wastewater (HWW), a domain that has largely been overlooked by researchers. AIM To evaluate the occurrence of multidrug-resistant bacteria in hospital wastewater of the Korle Bu Teaching Hospital (KBTH). METHODOLOGY This was a longitudinal study involving 288 HWW samples consecutively collected across 12 weeks from the pool of wastewater emanating from 2 critical care units of KBTH-The Child Health Unit and the Maternity Unit-on Mondays and Thursdays, each week. The samples were cultured for bacteria, which were identified using the Matrix-Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) technique and subjected to antimicrobial susceptibility testing via the Kirby-Bauer method. RESULTS In total, 294 bacteria of 23 different types, all being Gram-negative, were isolated from the 288 samples. The predominant ones were Escherichia coli (30.6%, n = 90), Klebsiella pneumoniae (11.2%, n = 33), Citrobacter freundii (10.9%, n = 32), Alcaligenes faecalis (5.8%, n = 17), and Pseudomonas mendocina (5.4%, n = 16). The prevalence of multidrug resistance among the isolates was 55.4% (n = 163). Moreover, the prevalence of extended-spectrum beta-lactamase (ESBL) producers was 15.6% (n = 46). E. coli accounted for the most ESBL-producing organisms (28.9%, n = 26). CONCLUSION The wastewater generated by the Maternity and Child Health Units of KBTH harbored a wide range of multidrug resistant bacteria, with a good proportion of these being ESBL producers, and the predominant one being E. coli. The study thus identifies the wastewater of KBTH as an important source of multidrug resistant organisms, and underscores the significance of appropriate treatment of wastewater of the hospital and other clinical, and related settings prior to its discharge.
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Affiliation(s)
- Daisy S Addae-Nuku
- Department of Medical Microbiology,
University of Ghana Medical School, Accra, Ghana
| | - Fleischer CN Kotey
- Department of Medical Microbiology,
University of Ghana Medical School, Accra, Ghana
- FleRhoLife Research Consult, Teshie,
Accra, Ghana
| | - Nicholas TKD Dayie
- Department of Medical Microbiology,
University of Ghana Medical School, Accra, Ghana
| | - Mary-Magdalene Osei
- Department of Medical Microbiology,
University of Ghana Medical School, Accra, Ghana
- FleRhoLife Research Consult, Teshie,
Accra, Ghana
| | - Edem MA Tette
- Department of Community Health,
University of Ghana Medical School, Accra, Ghana
| | - Philip Debrah
- Department of Pharmaceutics and
Microbiology, School of Pharmacy, College of Health Sciences, University of Ghana,
Legon, Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology,
University of Ghana Medical School, Accra, Ghana
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10
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Kotey FCN, Awugah SA, Dayie NTKD, Tetteh-Quarcoo PB, Duodu S, Osei MM, Bentum JN, Nyarko MY, Neizer ML, Alsharif KF, Halawani IF, Alzahrani KJ, Donkor ES. High prevalence of methicillin-resistant Staphylococcus aureus carriage among infants at the Children’s Hospital, Accra, Ghana. J Infect Dev Ctries 2022; 16:1450-1457. [DOI: 10.3855/jidc.14839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 09/20/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction: Infants are at risk of Staphylococcus aureus (S. aureus) colonization and infection. The aim of this study was to investigate S. aureus and methicillin-resistant S. aureus (MRSA) colonization among infants, including the prevalence, predictors of colonization, and antibiogram.
Methodology: The study was cross-sectional, and involved infants aged less than one year recruited at the Princess Marie Louise Children’s Hospital in Accra, Ghana. Sociodemographic and clinical data of the participants were gathered with a structured questionnaire. Nasal swabs were also obtained from them and bacteriologically cultured. S. aureus was confirmed with the coagulase test, and MRSA was confirmed by polymerase chain reaction (PCR) of the mecA gene. Antimicrobial susceptibility testing of S. aureus was done using the Kirby-Bauer method.
Results: The carriage prevalence of S. aureus and MRSA were 34.9% (45/129) and 17.10% (22/129), respectively. Colonization with coagulase-negative Staphylococci (CoNS) was protective of both S. aureus (OR = 0.008; p < 0.001) and MRSA (OR = 0.052; p = 0.005) carriage. Maintenance of good hand hygiene prevented S. aureus carriage (OR = 0.16; p < 0.001). S. aureus resistance to antibiotics decreased across penicillin (96%), trimethoprim-sulfamethoxazole (61%), tetracycline (61%), erythromycin (39%), gentamicin (39%), fusidic acid (26%), rifampicin (17%), clindamycin (7%), and linezolid (0%); 68.8% S. aureus were multidrug resistant.
Conclusions: S. aureus and MRSA prevalence were high among the infants. Colonization with CoNS and good hand hygiene maintenance were predictive of MRSA and methicillin-sensitive S. aureus (MSSA) colonization, respectively.
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11
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Dayie NT, Bannah V, Dwomoh FP, Kotey FC, Donkor ES. Distribution and Antimicrobial Resistance Profiles of Bacterial Aetiologies of Childhood Otitis Media in Accra, Ghana. Microbiol Insights 2022; 15:11786361221104446. [PMID: 35734305 PMCID: PMC9208041 DOI: 10.1177/11786361221104446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Otitis media (OM), also known as middle ear infection, is a clinically significant childhood disease. In sub-Saharan Africa, there is a paucity of contemporary reports on it is bacterial aetiologies and antimicrobial resistance among them. Aim: To investigate the OM bacterial aetiologies and their antimicrobial resistance patterns among children visiting the Ear, Nose, and Throat clinics of 3 healthcare facilities in Accra, Ghana – Princess Marie Louise Children’s Hospital, 37 Military Hospital, and Mamprobi Hospital. Methods: This cross-sectional study involved 100 children below 13 years old with suppurative otitis media. Following standard bacteriological methods, sterile ear swabs were used to take middle ear discharges from the study participants for culture and antimicrobial susceptibility testing. A standard questionnaire was also used to collect data on socio-demographic and clinical characteristics. Results: The major OM bacterial aetiologies were Pseudomonas aeruginosa (38.5%), Klebsiella pneumoniae (19.8%), Proteus mirabilis (11.5%), and Staphylococcus aureus (10.4%). The majority of the bacteria demonstrated low to moderate resistance (0%-33.3%) to most of the antibiotics. Eight of the bacteria (4 each of Klebsiella pneumoniae and Escherichia coli) were extended-spectrum beta-lactamase (ESBL) producers; 6 ampicillinase (Amp C)-producing organisms (4 Citrobacter spp. and one each of Morganella morganii and Serratia marcescens) were also identified, and they showed high antibiotic resistance. Conclusions: The predominant OM aetiologies were Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus, and they were generally susceptible to most of the antibiotics tested. Amikacin, cefepime, ciprofloxacin, and meropenem could be valuable in the empirical management of childhood OM.
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Affiliation(s)
- Nicholas Tkd Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Vida Bannah
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Felicia P Dwomoh
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.,Department of Medical Laboratory, University of Ghana Medical Centre, Legon, Accra, Ghana
| | - Fleischer Cn Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.,FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
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12
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Ndlangisa KM, du Plessis M, Lo S, de Gouveia L, Chaguza C, Antonio M, Kwambana-Adams B, Cornick J, Everett DB, Dagan R, Hawkins PA, Beall B, Corso A, Grassi Almeida SC, Ochoa TJ, Obaro S, Shakoor S, Donkor ES, Gladstone RA, Ho PL, Paragi M, Doiphode S, Srifuengfung S, Ford R, Moïsi J, Saha SK, Bigogo G, Sigauque B, Eser ÖK, Elmdaghri N, Titov L, Turner P, Kumar KLR, Kandasamy R, Egorova E, Ip M, Breiman RF, Klugman KP, McGee L, Bentley SD, von Gottberg A, The Global Pneumococcal Sequencing Consortium. A Streptococcus pneumoniae lineage usually associated with pneumococcal conjugate vaccine (PCV) serotypes is the most common cause of serotype 35B invasive disease in South Africa, following routine use of PCV. Microb Genom 2022; 8. [PMID: 35384831 PMCID: PMC9453074 DOI: 10.1099/mgen.0.000746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pneumococcal serotype 35B is an important non-conjugate vaccine (non-PCV) serotype. Its continued emergence, post-PCV7 in the USA, was associated with expansion of a pre-existing 35B clone (clonal complex [CC] 558) along with post-PCV13 emergence of a non-35B clone previously associated with PCV serotypes (CC156). This study describes lineages circulating among 35B isolates in South Africa before and after PCV introduction. We also compared 35B isolates belonging to a predominant 35B lineage in South Africa (GPSC5), with isolates belonging to the same lineage in other parts of the world. Serotype 35B isolates that caused invasive pneumococcal disease in South Africa in 2005–2014 were characterized by whole-genome sequencing (WGS). Multi-locus sequence types and global pneumococcal sequence clusters (GPSCs) were derived from WGS data of 63 35B isolates obtained in 2005–2014. A total of 262 isolates that belong to GPSC5 (115 isolates from South Africa and 147 from other countries) that were sequenced as part of the global pneumococcal sequencing (GPS) project were included for comparison. Serotype 35B isolates from South Africa were differentiated into seven GPSCs and GPSC5 was most common (49 %, 31/63). While 35B was the most common serotype among GPSC5/CC172 isolates in South Africa during the PCV13 period (66 %, 29/44), 23F was the most common serotype during both the pre-PCV (80 %, 37/46) and PCV7 period (32 %, 8/25). Serotype 35B represented 15 % (40/262) of GPSC5 isolates within the global GPS database and 75 % (31/40) were from South Africa. The predominance of the GPSC5 lineage within non-vaccine serotype 35B, is possibly unique to South Africa and warrants further molecular surveillance of pneumococci.
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Affiliation(s)
- Kedibone M Ndlangisa
- National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Mignon du Plessis
- National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephanie Lo
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, UK
| | - Linda de Gouveia
- National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service, Johannesburg, South Africa
| | | | - Martin Antonio
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit, The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Brenda Kwambana-Adams
- NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection and Immunity, University College London, London, UK.,West Africa Partnerships and Strategies, Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Fajara, Gambia
| | | | - Dean B Everett
- Malawi-Liverpool-Wellcome-Trust, Blantyre, Malawi.,Centre for Inflammation Research, Queens Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ron Dagan
- The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Paulina A Hawkins
- Rollins School Public Health, Emory University, Atlanta, USA.,Centers for Disease Control and Prevention, Atlanta, USA
| | - Bernard Beall
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Alejandra Corso
- Administración Nacional de Laboratorios e Institutos de Salud, Buenos Aires, Argentina
| | | | - Theresa J Ochoa
- Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | | | - Pak Leung Ho
- Department of Microbiology and Carol Yu Centre for Infection, The University of Hong Kong, Queen Mary Hospital, Hong Kong, PR China
| | - Metka Paragi
- National Laboratory of Health, Environment and Food, Ljubljana, Slovenia
| | | | | | - Rebecca Ford
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | | | - Samir K Saha
- Child Health Research Foundation, Dhaka, Bangladesh
| | | | - Betuel Sigauque
- Centro de Investigação em Saúde da Manhiça, Maputo, Moçambique
| | - Özgen Köseoglu Eser
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Naima Elmdaghri
- Faculty of Medicine and Pharmacy & Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Leonid Titov
- The Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Belarus
| | - Paul Turner
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - K L Ravi Kumar
- Kempegowda Institute of Medical Sciences Hospital & Research Center, Bangalore, India
| | - Rama Kandasamy
- University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Ekaterina Egorova
- G. N. Gabrichevsky Research Institute for Epidemiology and Microbiology, Moscow, Russia
| | - Margaret Ip
- Department of Microbiology, Chinese University of Hong Kong, Hong Kong, PR China
| | | | - Keith P Klugman
- School of Pathology, University of the Witwatersrand, Johannesburg, South Africa.,Hubert Department of Global Health, Rollins School of Public Health, and Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Lesley McGee
- Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Anne von Gottberg
- National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
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13
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Dayie NTKD, Sekoh DNK, Tetteh-Quarcoo PB, Dayie AD, Osei MM, Kotey FCN, Donkor ES. Staphylococcus aureus Nasopharyngeal Carriage and Antimicrobial Resistance among Adults with Sickle Cell Disease at the Korle Bu Teaching Hospital in Accra, Ghana. Microbiol Insights 2022; 15:11786361221133959. [PMID: 36339725 PMCID: PMC9629541 DOI: 10.1177/11786361221133959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/03/2022] [Indexed: 11/08/2022] Open
Abstract
Background: Sickle cell disease (SCD) patients are an important risk group for Staphylococcus aureus ( S. aureus) carriage and infections. Little is, however, known about the nasopharyngeal carriage epidemiology of the pathogen in this vulnerable population. Aim: The aim of this study was to evaluate S. aureus and methicillin-resistant S. aureus (MRSA) nasopharyngeal carriage prevalence, carriage determinants, and antimicrobial resistance among SCD adults in Ghana. Methodology: Nasopharyngeal swabs, obtained from 200 SCD adults recruited at the Korle Bu Teaching Hospital, were cultured for S. aureus, and these isolates were subjected to antimicrobial susceptibility testing via the Kirby-Bauer method. Results: The prevalence of S. aureus carriage was 41.5% (n = 83), and that of MRSA carriage was 1.0% (n = 2). Moreover, carriage of coagulase-negative Staphylococcus (CoNS) was the only determinant of S. aureus carriage identified (OR = 0.012, P < .0001). However, neither this variable nor the other features of the participants emerged as a determinant of MRSA carriage. The antimicrobial resistance rates decreased across penicillin (98.8%, n = 82), tetracycline (54.2%, n = 45), gentamicin (32.5%, n = 27), ciprofloxacin (21.7%, n = 18), erythromycin (18.1%, n = 15), clindamycin (10.8%, n = 9), amoxicillin-clavulanic acid (10.8%, n = 9), teicoplanin (1.2%, n = 1), and linezolid (0.0%, n = 0), and the multidrug resistance rate was 45.8% (n = 38). Conclusion: The nasopharyngeal carriage prevalence of S. aureus in the current study was high, while that of MRSA was low. The isolates were highly resistant to several of the antibiotics tested, but not teicoplanin and linezolid, making these antibiotics suitable for treatment of S. aureus infections among the SCD population.
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Affiliation(s)
- Nicholas TKD Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Deborah NK Sekoh
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
- FleRhoLife Research Consult, Teshie, Accra, Ghana
| | | | - Alberta D Dayie
- Department of Chemistry, University of Cape Coast, Cape Coast, Ghana
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
- FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Fleischer CN Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
- FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
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14
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Anafo RB, Atiase Y, Dayie NTKD, Kotey FCN, Tetteh-Quarcoo PB, Duodu S, Osei MM, Alzahrani KJ, Donkor ES. Methicillin-Resistant Staphylococcus aureus (MRSA) Infection of Diabetic Foot Ulcers at a Tertiary Care Hospital in Accra, Ghana. Pathogens 2021; 10:pathogens10080937. [PMID: 34451401 PMCID: PMC8398970 DOI: 10.3390/pathogens10080937] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 12/27/2022] Open
Abstract
Aim: This study investigated the spectrum of bacteria infecting the ulcers of individuals with diabetes at the Korle Bu Teaching Hospital in Accra, Ghana, focusing on Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA), with respect to their prevalence, factors predisposing to their infection of the ulcers, and antimicrobial resistance patterns. Methodology: This cross-sectional study was conducted at The Ulcer Clinic, Department of Surgery, Korle Bu Teaching Hospital, involving 100 diabetic foot ulcer patients. The ulcer of each study participant was swabbed and cultured bacteriologically, following standard procedures. Antimicrobial susceptibility testing was done for all S. aureus isolated, using the Kirby-Bauer method. Results: In total, 96% of the participants had their ulcers infected—32.3% (n = 31) of these had their ulcers infected with one bacterium, 47.9% (n = 46) with two bacteria, 18.8% (n = 18) with three bacteria, and 1.0% (n = 1) with four bacteria. The prevalence of S. aureus and MRSA were 19% and 6%, respectively. The distribution of the other bacteria was as follows: coagulase-negative Staphylococci (CoNS) (54%), Escherichia coli (24%), Pseudomonas spp. (19%), Citrobacter koseri and Morganella morgana (12% each), Klebsiella oxytoca (11%), Proteus vulgaris (8%), Enterococcus spp. (6%), Klebsiella pneumoniae (5%), Proteus mirabilis and Enterobacter spp. (4%), Klebsiella spp. (2%), and Streptococcus spp. (1%). The resistance rates of S. aureus decreased across penicillin (100%, n = 19), tetracycline (47.4%, n = 9), cotrimoxazole (42.1%, n = 8), cefoxitin (31.6%, n = 6), erythromycin and clindamycin (26.3% each, n = 5), norfloxacin and gentamicin (15.8% each, n = 3), rifampicin (10.5%, n = 2), linezolid (5.3%, n = 1), and fusidic acid (0.0%, n = 0). The proportion of multidrug resistance was 47.4% (n = 9). Except for foot ulcer infection with coagulase-negative Staphylococci, which was protective of S. aureus infection of the ulcers (OR = 0.029, p = 0.001, 95% CI = 0.004–0.231), no predictor of S. aureus, MRSA, or polymicrobial ulcer infection was identified. Conclusions: The prevalence of S. aureus and MRSA infection of the diabetic foot ulcers were high, but lower than those of the predominant infector, coagulase-negative Staphylococci and the next highest infecting agent, E. coli. Diabetic foot ulcers’ infection with coagulase-negative Staphylococci protected against their infection with S. aureus. The prevalence of multidrug resistance was high, highlighting the need to further intensify antimicrobial stewardship programmes.
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Affiliation(s)
- Ramzy B. Anafo
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (R.B.A.); (N.T.K.D.D.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.)
| | - Yacoba Atiase
- Department of Medicine, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana;
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (R.B.A.); (N.T.K.D.D.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.)
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (R.B.A.); (N.T.K.D.D.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.)
- FleRhoLife Research Consult, Accra P.O. Box TS 853, Ghana
| | - Patience B. Tetteh-Quarcoo
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (R.B.A.); (N.T.K.D.D.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.)
| | - Samuel Duodu
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra P.O. Box LG 54, Ghana;
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra P.O. Box LG 54, Ghana
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (R.B.A.); (N.T.K.D.D.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.)
- FleRhoLife Research Consult, Accra P.O. Box TS 853, Ghana
| | - Khalid J. Alzahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif P.O. Box 11099, Saudi Arabia;
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (R.B.A.); (N.T.K.D.D.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.)
- Correspondence: or
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15
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Narwortey DK, Owusu-Ofori A, Slotved HC, Donkor ES, Ansah PO, Welaga P, Agongo G, Oduro AR. Nasopharyngeal carriage of Streptococcus pneumoniae among healthy children in Kassena-Nankana districts of Northern Ghana. BMC Infect Dis 2021; 21:661. [PMID: 34233627 PMCID: PMC8265090 DOI: 10.1186/s12879-021-06302-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pneumococcal vaccine immunizations may be responsible for alterations in serotype epidemiology within a region. This study investigated the pneumococcal carriage prevalence and the impact of the 13-valent pneumococcal conjugate vaccine (PCV-13) on circulating serotypes among healthy children in Northern Ghana. METHODS This was a cross sectional study conducted in the Kassena-Nankana districts of Northern Ghana from November to December during the dry season of 2018. Nasopharyngeal swabs collected from 193 participants were cultured per standard microbiological protocols and pneumococcal isolates were serotyped using the latex agglutination technique and the capsular Quellung reaction test. We examined for any association between the demographic characteristics of study participants and pneumococcal carriage using chi-square test and logistic regression. RESULTS Of the 193 participants that were enrolled the mean age was 8.6 years and 54.4% were females. The carriage rate among the participants was 32.6% (63/193), and twenty different serotypes were identified. These included both vaccine serotypes (VT), 35% (7/20) and non-vaccine serotypes (NVT), 65% (13/20). The predominant serotypes (34 and 11A), both of which were NVT, accounted for a prevalence of 12.8%. PCV-13 covered only 35% of serotypes identified whiles 40% of serotypes are covered by PPV 23. CONCLUSION Post-vaccination carriage of S. pneumoniae is high and is dominated by non-vaccine serotypes. There is therefore a need for the conduct of invasive pneumococcal disease surveillance (IPD) to find out if the high non-vaccine serotype carriage translates to disease. And in addition, a review of the currently used PCV-13 vaccine in the country would be considered relevant.
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Affiliation(s)
- Deborah K. Narwortey
- Navrongo Health Research Centre, Ghana Health Services, Biomedical Department, P.O. Box 114, Navrongo, Ghana
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alex Owusu-Ofori
- Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Patrick O. Ansah
- Navrongo Health Research Centre, Ghana Health Services, Biomedical Department, P.O. Box 114, Navrongo, Ghana
| | - Paul Welaga
- Navrongo Health Research Centre, Ghana Health Services, Biomedical Department, P.O. Box 114, Navrongo, Ghana
| | - Godfred Agongo
- Navrongo Health Research Centre, Ghana Health Services, Biomedical Department, P.O. Box 114, Navrongo, Ghana
| | - Abraham R. Oduro
- Navrongo Health Research Centre, Ghana Health Services, Biomedical Department, P.O. Box 114, Navrongo, Ghana
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Kotey FCN, Dayie NTKD, Tetteh-Uarcoo PB, Donkor ES. Candida Bloodstream Infections: Changes in Epidemiology and Increase in Drug Resistance. Infect Dis (Lond) 2021; 14:11786337211026927. [PMID: 34248358 PMCID: PMC8236779 DOI: 10.1177/11786337211026927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/30/2021] [Indexed: 11/17/2022] Open
Abstract
The literature on bloodstream infections (BSIs) have predominantly been biased towards bacteria, given their superior clinical significance in comparison with the other types of microorganisms. Fungal pathogens have epidemiologically received relatively less attention, although they constitute an important proportion of BSI aetiologies. In this review, the authors discuss the clinical relevance of fungal BSIs in the context of Candida species, as well as treatment options for the infections, emphasizing the compelling need to develop newer antifungals and strengthen antimicrobial stewardship programmes in the wake of the rapid spread of antifungal resistance.
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Affiliation(s)
- Fleischer CN Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
- FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Nicholas TKD Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | | | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana
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Sumabe BK, Ræder SB, Røst LM, Sharma A, Donkor ES, Mosi L, Duodu S, Bruheim P, Otterlei M. Nucleoside Analogues Are Potent Inducers of Pol V-mediated Mutagenesis. Biomolecules 2021; 11:843. [PMID: 34198819 PMCID: PMC8227612 DOI: 10.3390/biom11060843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/18/2022] Open
Abstract
Drugs targeting DNA and RNA in mammalian cells or viruses can also affect bacteria present in the host and thereby induce the bacterial SOS system. This has the potential to increase mutagenesis and the development of antimicrobial resistance (AMR). Here, we have examined nucleoside analogues (NAs) commonly used in anti-viral and anti-cancer therapies for potential effects on mutagenesis in Escherichia coli, using the rifampicin mutagenicity assay. To further explore the mode of action of the NAs, we applied E. coli deletion mutants, a peptide inhibiting Pol V (APIM-peptide) and metabolome and proteome analyses. Five out of the thirteen NAs examined, including three nucleoside reverse transcriptase inhibitors (NRTIs) and two anti-cancer drugs, increased the mutation frequency in E. coli by more than 25-fold at doses that were within reported plasma concentration range (Pl.CR), but that did not affect bacterial growth. We show that the SOS response is induced and that the increase in mutation frequency is mediated by the TLS polymerase Pol V. Quantitative mass spectrometry-based metabolite profiling did not reveal large changes in nucleoside phosphate or other central carbon metabolite pools, which suggests that the SOS induction is an effect of increased replicative stress. Our results suggest that NAs/NRTIs can contribute to the development of AMR and that drugs inhibiting Pol V can reverse this mutagenesis.
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Affiliation(s)
- Balagra Kasim Sumabe
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway; (B.K.S.); (S.B.R.)
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, P.O. BOX LG 54 Accra, Ghana; (L.M.); (S.D.)
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, P.O. BOX LG 54 Accra, Ghana
| | - Synnøve Brandt Ræder
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway; (B.K.S.); (S.B.R.)
| | - Lisa Marie Røst
- Department of Biotechnology and Food Science, Faculty of Natural Sciences, NTNU Norwegian University of Science and Technology, NO-7481 Trondheim, Norway; (L.M.R.); (P.B.)
| | - Animesh Sharma
- Proteomics and Modomics Experimental Core Facility (PROMEC), NTNU Norwegian University of Science and Technology, NO-7481 Trondheim, Norway;
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box 4236 Accra, Ghana;
| | - Lydia Mosi
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, P.O. BOX LG 54 Accra, Ghana; (L.M.); (S.D.)
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, P.O. BOX LG 54 Accra, Ghana
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, P.O. BOX LG 54 Accra, Ghana; (L.M.); (S.D.)
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, P.O. BOX LG 54 Accra, Ghana
| | - Per Bruheim
- Department of Biotechnology and Food Science, Faculty of Natural Sciences, NTNU Norwegian University of Science and Technology, NO-7481 Trondheim, Norway; (L.M.R.); (P.B.)
| | - Marit Otterlei
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway; (B.K.S.); (S.B.R.)
- Clinic of Laboratory medicine, St. Olav University Hospital, NO-7006 Trondheim, Norway
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Tetteh-Quarcoo PB, Dayie NTKD, Adutwum-Ofosu KK, Ahenkorah J, Afutu E, Amponsah SK, Abdul-Rahman M, Kretchy JP, Ocloo JY, Nii-Trebi NI, Yalley AK, Hagan OCK, Niriwa BP, Aghasili CC, Kotey FCN, Donkor ES, Ayeh-Kumi PF, Udofia EA. Unravelling the Perspectives of Day and Night Traders in Selected Markets within a Sub-Saharan African City with a Malaria Knowledge, Attitude and Practice Survey. Int J Environ Res Public Health 2021; 18:ijerph18073468. [PMID: 33810537 PMCID: PMC8037644 DOI: 10.3390/ijerph18073468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/20/2022]
Abstract
Background: Malaria is still endemic in sub-Saharan Africa, with a high disease burden. Misconceptions about malaria contribute to poor attitudes and practices, further increasing the burden in endemic countries. Studies have examined the knowledge, attitudes, and practices (KAP) of malaria among different populations. However, there seems to be no available literature reporting on the perspectives of day and night market traders. To the best of our knowledge, this is the first report on malaria KAP with a focus on day and night market traders. Methods: A descriptive cross-sectional study involving day and night market traders in 10 selected markets within the Greater Accra Region of Ghana was carried out. Data were collected from consenting respondents using a structured questionnaire. Results: Of the 760 respondents (33.3% (n = 253) night and 66.7% (n = 507) day traders) interviewed, there was no significant difference between the day and night market traders in terms of malaria KAP. Although the market traders had an overall moderate knowledge (54.0% of the day traders and 56.5% of the night traders), misconceptions about malaria (especially that it could be caused by exposure to the sun) still existed among the traders. Moreover, the majority of the traders who demonstrated high knowledge (43.98%, n = 250) did not always take laboratory tests to confirm their suspicion, indicating poor attitude. Furthermore, the market traders’ choice of drug for malaria treatment (p = 0.001) and preferred malaria treatment type (orthodox or herbal) (p = 0.005) were significantly associated with their knowledge level. Conclusions: Despite the observation that no significant difference in KAP exists between day and night market traders, appropriate health education programs and interventions still need to be directed at misconceptions, poor attitudes, and poor practices revealed by this study. This will ultimately help in the prevention and control of malaria in Ghana, and globally.
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Affiliation(s)
- Patience B. Tetteh-Quarcoo
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (E.A.); (B.P.N.); (F.C.N.K.); (E.S.D.); (P.F.A.-K.)
- Correspondence: (P.B.T.-Q.); (N.T.K.D.D.); Tel.: +233-244633251 (P.B.T.-Q.); +233-208449415 (N.T.K.D.D.)
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (E.A.); (B.P.N.); (F.C.N.K.); (E.S.D.); (P.F.A.-K.)
- Correspondence: (P.B.T.-Q.); (N.T.K.D.D.); Tel.: +233-244633251 (P.B.T.-Q.); +233-208449415 (N.T.K.D.D.)
| | - Kevin Kofi Adutwum-Ofosu
- Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (K.K.A.-O.); (J.A.)
| | - John Ahenkorah
- Department of Anatomy, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (K.K.A.-O.); (J.A.)
| | - Emmanuel Afutu
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (E.A.); (B.P.N.); (F.C.N.K.); (E.S.D.); (P.F.A.-K.)
| | - Seth K. Amponsah
- Department of Medical Pharmacology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana;
| | - Mubarak Abdul-Rahman
- Department of Pathology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana;
| | - James-Paul Kretchy
- Department of Physician Assitantship Studies/Public Health, School of Medicine and Health Sciences, Central University, Miotso P.O. Box DS 2305, Accra, Ghana;
| | - Janet Y. Ocloo
- Department of Pathology, Korle-Bu Teaching Hospital, Korle-Bu, Accra P.O. Box 77 233, Ghana;
| | - Nicholas I. Nii-Trebi
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu, Accra P.O. Box KB 143, Ghana; (N.I.N.-T.); (A.K.Y.)
| | - Akua K. Yalley
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle Bu, Accra P.O. Box KB 143, Ghana; (N.I.N.-T.); (A.K.Y.)
| | - Oheneba C. K. Hagan
- Department of Medical Biochemistry, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana;
| | - Benjamin P. Niriwa
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (E.A.); (B.P.N.); (F.C.N.K.); (E.S.D.); (P.F.A.-K.)
- Holy Family Hospital, Techiman P.O. Box 36, Ghana
| | - Chukwuemeka C. Aghasili
- Department of Community Health, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (C.C.A.); (E.A.U.)
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (E.A.); (B.P.N.); (F.C.N.K.); (E.S.D.); (P.F.A.-K.)
- FleRhoLife Research Consult, Teshie, Accra P.O. Box TS 853, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (E.A.); (B.P.N.); (F.C.N.K.); (E.S.D.); (P.F.A.-K.)
| | - Patrick F. Ayeh-Kumi
- Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (E.A.); (B.P.N.); (F.C.N.K.); (E.S.D.); (P.F.A.-K.)
| | - Emilia Asuquo Udofia
- Department of Community Health, University of Ghana Medical School, Accra P.O. Box KB 4236, Ghana; (C.C.A.); (E.A.U.)
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Dayie NTKD, Sekoh DNK, Kotey FCN, Egyir B, Tetteh-Quarcoo PB, Adutwum-Ofosu KK, Ahenkorah J, Osei MM, Donkor ES. Nasopharyngeal Carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) among Sickle Cell Disease (SCD) Children in the Pneumococcal Conjugate Vaccine Era. Infect Dis Rep 2021; 13:191-204. [PMID: 33804397 PMCID: PMC7931118 DOI: 10.3390/idr13010022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/11/2021] [Accepted: 02/23/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this cross-sectional study was to investigate Staphylococcus aureus nasopharyngeal carriage epidemiology in relation to other nasopharyngeal bacterial colonizers among sickle cell disease (SCD) children about five years into pneumococcal conjugate vaccine 13 (PCV-13) introduction in Ghana. The study involved bacteriological culture of nasopharyngeal swabs obtained from 202 SCD children recruited from the Princess Marie Louise Children's Hospital. S. aureus isolates were identified using standard methods and subjected to antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method. Cefoxitin-resistant S. aureus isolates were screened for carriage of the mecA, pvl, and tsst-1 genes using multiplex polymerase chain reaction. The carriage prevalence of S. aureus was 57.9% (n = 117), and that of methicillin-resistant S. aureus (MRSA) was 3.5% (n = 7). Carriage of the mecA, pvl, and tsst-1 genes were respectively demonstrated in 20.0% (n = 7), 85.7% (n = 30), and 11.4% (n = 4) of the cefoxitin-resistant S. aureus isolates. PCV-13 vaccination (OR = 0.356, p = 0.004) and colonization with coagulase-negative staphylococci (CoNS) (OR = 0.044, p < 0.0001) each protected against S. aureus carriage. However, none of these and other features of the participants emerged as a determinant of MRSA carriage. The following antimicrobial resistance rates were observed in MRSA compared to methicillin-sensitive S. aureus: clindamycin (28.6% vs. 4.3%), erythromycin (42.9% vs. 19.1%), tetracycline (100% vs. 42.6%), teicoplanin (14.3% vs. 2.6%), penicillin (100% vs. 99.1%), amoxiclav (28.6% vs. 3.5%), linezolid (14.3% vs. 0.0%), ciprofloxacin (42.9% vs. 13.9%), and gentamicin (42.9% vs. 13.0%). The proportion of S. aureus isolates that were multidrug resistant was 37.7% (n = 46). We conclude that S. aureus was the predominant colonizer of the nasopharynx of the SCD children, warranting the continuous monitoring of this risk group for invasive S. aureus infections.
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Affiliation(s)
- Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236, Korle Bu, Accra 00233, Ghana; (D.N.K.S.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.); (E.S.D.)
| | - Deborah N. K. Sekoh
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236, Korle Bu, Accra 00233, Ghana; (D.N.K.S.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.); (E.S.D.)
- FleRhoLife Research Consult, P.O. Box TS 853, Teshie, Accra 00233, Ghana
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236, Korle Bu, Accra 00233, Ghana; (D.N.K.S.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.); (E.S.D.)
- FleRhoLife Research Consult, P.O. Box TS 853, Teshie, Accra 00233, Ghana
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra 00233, Ghana;
| | - Patience B. Tetteh-Quarcoo
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236, Korle Bu, Accra 00233, Ghana; (D.N.K.S.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.); (E.S.D.)
| | - Kevin Kofi Adutwum-Ofosu
- Department of Anatomy, University of Ghana Medical School, P.O. Box KB 4236, Korle Bu, Accra 00233, Ghana; (K.K.A.-O.); (J.A.)
| | - John Ahenkorah
- Department of Anatomy, University of Ghana Medical School, P.O. Box KB 4236, Korle Bu, Accra 00233, Ghana; (K.K.A.-O.); (J.A.)
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236, Korle Bu, Accra 00233, Ghana; (D.N.K.S.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.); (E.S.D.)
- FleRhoLife Research Consult, P.O. Box TS 853, Teshie, Accra 00233, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236, Korle Bu, Accra 00233, Ghana; (D.N.K.S.); (F.C.N.K.); (P.B.T.-Q.); (M.-M.O.); (E.S.D.)
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Egyir B, Bentum J, Attram N, Fox A, Obeng-Nkrumah N, Appiah-Korang L, Behene E, Kumordjie S, Yeboah C, Agbodzi B, Bentil RE, Tagoe R, Kofi Adu Tabi B, Owusu F, Dayie NTKD, Donkor ES, Nsaful J, Asah-Opoku K, Nyarko E, Asumanu E, Larsen AR, Wolfe DM, Letizia AG. Whole Genome Sequencing and Antimicrobial Resistance of Staphylococcus aureus from Surgical Site Infections in Ghana. Pathogens 2021; 10:pathogens10020196. [PMID: 33673230 PMCID: PMC7918159 DOI: 10.3390/pathogens10020196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022] Open
Abstract
Staphylococcus aureus (S. aureus) is a common cause of surgical site infections (SSIs) globally. Data on the occurrence of methicillin-susceptible S. aureus (MSSA) as well as methicillin-resistant S. aureus (MRSA) among patients with surgical site infections (SSIs) in sub-Saharan African are scarce. We characterized S. aureus from SSIs in Ghana using molecular methods and antimicrobial susceptibility testing (AST). Wound swabs or aspirate samples were collected from subjects with SSIs. S. aureus was identified by matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF-MS); AST was performed by Kirby-Bauer disk diffusion, and results were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guideline. Detection of spa, mecA, and pvl genes was performed by polymerase chain reaction (PCR). Whole-genome sequencing (WGS) was done using the Illumina MiSeq platform. Samples were collected from 112 subjects, with 13 S. aureus isolates recovered. Of these, 92% were sensitive to co-trimoxazole, 77% to clindamycin, and 54% to erythromycin. Multi-drug resistance was detected in 5 (38%) isolates. The four mecA gene-positive MRSA isolates detected belonged to ST152 (n = 3) and ST5 (n = 1). In total, 62% of the isolates were positive for the Panton-Valentine leukocidin (pvl) toxin gene. This study reports, for the first time, a pvl-positive ST152-t355 MRSA clone from SSIs in Ghana. The occurrence of multi-drug-resistant S. aureus epidemic clones suggests that continuous surveillance is required to monitor the spread and resistance trends of S. aureus in hospital settings in the country.
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Affiliation(s)
- Beverly Egyir
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Correspondence:
| | - Jeannette Bentum
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Naiki Attram
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Anne Fox
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra 00233, Ghana;
| | - Labi Appiah-Korang
- Department of Microbiology, Korle-Bu Teaching Hospital, Accra 00233, Ghana;
| | - Eric Behene
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Selassie Kumordjie
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Clara Yeboah
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Bright Agbodzi
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Ronald Essah Bentil
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Rhodalyn Tagoe
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
| | - Blessing Kofi Adu Tabi
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
| | - Felicia Owusu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana; (N.T.K.D.D.); (E.S.D.)
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana; (N.T.K.D.D.); (E.S.D.)
| | - Josephine Nsaful
- Department of Surgery, Korle-bu Teaching Hospital, Accra 00233, Ghana;
| | - Kwaku Asah-Opoku
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana;
| | - Edward Nyarko
- 37 Military Hospital, Accra 00233, Ghana; (E.N.); (E.A.)
| | - Edward Asumanu
- 37 Military Hospital, Accra 00233, Ghana; (E.N.); (E.A.)
| | - Anders Rhod Larsen
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Reference Laboratory for Antimicrobial Resistance, Artillerivej 5, DK-2300 Copenhagen, Denmark;
| | - David M. Wolfe
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Andrew G. Letizia
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
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Prusakov P, Goff DA, Wozniak PS, Cassim A, Scipion CE, Urzúa S, Ronchi A, Zeng L, Ladipo-Ajayi O, Aviles-Otero N, Udeigwe-Okeke CR, Melamed R, Silveira RC, Auriti C, Beltrán-Arroyave C, Zamora-Flores E, Sanchez-Codez M, Donkor ES, Kekomäki S, Mainini N, Trochez RV, Casey J, Graus JM, Muller M, Singh S, Loeffen Y, Pérez MET, Ferreyra GI, Lima-Rogel V, Perrone B, Izquierdo G, Cernada M, Stoffella S, Ekenze SO, de Alba-Romero C, Tzialla C, Pham JT, Hosoi K, Consuegra MCC, Betta P, Hoyos OA, Roilides E, Naranjo-Zuñiga G, Oshiro M, Garay V, Mondì V, Mazzeo D, Stahl JA, Cantey JB, Monsalve JGM, Normann E, Landgrave LC, Mazouri A, Avila CA, Piersigilli F, Trujillo M, Kolman S, Delgado V, Guzman V, Abdellatif M, Monterrosa L, Tina LG, Yunis K, Rodriguez MAB, Saux NL, Leonardi V, Porta A, Latorre G, Nakanishi H, Meir M, Manzoni P, Norero X, Hoyos A, Arias D, Sánchez RG, Medoro AK, Sánchez PJ. A global point prevalence survey of antimicrobial use in neonatal intensive care units: The no-more-antibiotics and resistance (NO-MAS-R) study. EClinicalMedicine 2021; 32:100727. [PMID: 33554094 PMCID: PMC7848759 DOI: 10.1016/j.eclinm.2021.100727] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts. METHODS We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality. FINDINGS On July 1, 2019, 26% of infants (580/2,265; range, 0-100%; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received ≥1 antimicrobial agent (92%, antibacterial; 19%, antifungal; 4%, antiviral). The most common reasons for antibiotic therapy were "rule-out" sepsis (32%) and "culture-negative" sepsis (16%) with ampicillin (40%), gentamicin (35%), amikacin (19%), vancomycin (15%), and meropenem (9%) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26%), amikacin (20%), and meropenem (16%) were the most prescribed agents. Length of therapy for culture-positive and "culture-negative" infections was 12 days (median; IQR, 8-14) and 7 days (median; IQR, 5-10), respectively. Mortality was 6% (42%, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0·02). INTERPRETATION Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide. FUNDING Merck & Co.; The Ohio State University College of Medicine Barnes Medical Student Research Scholarship.
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Affiliation(s)
- Pavel Prusakov
- Department of Pharmacy, Nationwide Children's Hospital, Columbus, OH, USA
| | - Debra A. Goff
- Department of Pharmacy, The Ohio State University Wexner Medical Center, The Ohio State University College of Pharmacy, Columbus, OH, USA
| | | | - Azraa Cassim
- Chris Hani Baragwanath Hospital, Johannesburg, South Africa
| | | | - Soledad Urzúa
- Department of Neonatology, Pontificia Universidad Catolica, Santiago, Chile
| | - Andrea Ronchi
- Division of Neonatology and NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lingkong Zeng
- Department of Neonatology, Wuhan Children's Hospital Wuhan Maternal and Child Healthcare Hospital Tongji Medical College Huazhong University of Science & Technology, Wuhan, China
| | | | | | | | - Rimma Melamed
- Pediatric Infectious Diseases Unit and Faculty of Health Sciences, Ben Gurion University of the Negev, Soroka University Medical Center, Beer Sheva, Israel
| | - Rita C. Silveira
- Department of Pediatrics, Newborn Section, Universidade Federal do Rio Grande do Sul. Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Cinzia Auriti
- Department of Neonatology, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Elena Zamora-Flores
- Division of Neonatology, Hospital Materno Infantil Gregorio Marañon University Hospital, Madrid, Spain
| | - Maria Sanchez-Codez
- Division of Pediatric Infectious Diseases, Puerta del Mar University Hospital, Cadiz, Spain
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Satu Kekomäki
- Division of Pediatric Infectious Diseases, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | | | | | - Jamalyn Casey
- Department of Pharmacy, St. Vincent Women's Hospital, Indianapolis, IN, United States
| | - Juan M. Graus
- Department of Neonatology, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Mallory Muller
- Department of Pharmacy, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Sara Singh
- University of Guyana, School of Medicine, Georgetown, Guyana
| | - Yvette Loeffen
- Division of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, Utrecht, Netherlands
| | - María Eulalia Tamayo Pérez
- Coordinator of Neonatology Fellow Program, Head of Neonatal Intensive Care, University of Antioquia, Hospital San Vicente Fundacion, Medellin, Colombia
| | - Gloria Isabel Ferreyra
- Department of Neonatology, Instituto de Maternidad Ntra. Sra. de las Mercedes, San Miguel de Tucumán, Argentina
| | - Victoria Lima-Rogel
- Division of Neonatology, Hospital General Dr. Ignacio Morones Prieto, San Luis Potosi, Mexico
| | - Barbara Perrone
- Division of Neonatology and NICU, G. Salesi Children's Hospital, Ancona, Italy
| | - Giannina Izquierdo
- Division of Neonatology and Pediatric Infectious Diseases, Hospital Barros Luco Trudeau, Santiago, Chile
| | - María Cernada
- Division of Neonatology and Neonatal Research Group, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Sylvia Stoffella
- Department of Pharmacy, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | | | | | | | - Jennifer T. Pham
- Department of Pharmacy, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | - Kenichiro Hosoi
- Department of Pediatrics, Kyorin University School of Medicine, Tokyo, Japan
| | | | - Pasqua Betta
- Division of Neonatology and NICU, AOU Policlinico G Rodolico, Catania, Italy
| | - O. Alvaro Hoyos
- Clínica Universitaria Bolivariana/Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Emmanuel Roilides
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Makoto Oshiro
- Department of Pediatrics, Nagoya Red Cross Daiichi Hospital, Nagoya, Japan
| | - Victor Garay
- Division of Neonatology, Alberto Sabogal Hospital, Lima, Peru
| | | | - Danila Mazzeo
- Division of Patology and Intensive Neonatal Care, A.O.U. Policlinico di Messina, Messina, Italy
| | - James A. Stahl
- Department of Pharmacy, Norton Children's Hospital, Louisville, KY, USA
| | - Joseph B. Cantey
- Department of Pediatrics, Division of Neonatology, University Hospital UT Health San Antonio, San Antonio, TX
| | | | - Erik Normann
- Department of Women's and Children's Health, Uppsala University, Uppsala University Children's Hospital, Uppsala, Sweden
| | | | - Ali Mazouri
- Iran University of Medical Sciences, Tehran, Iran
| | - Claudia Alarcón Avila
- Department of Perinatology and Neonatology, Central Military Hospital, Nueva Granada Military University, Bogotá, Colombia
| | | | - Monica Trujillo
- Program Coordinator Pediatric Infectious Diseases Clinica Universiraria Bolivariana, Hospital Pablo Tobon Uribe, Medellin, Colombia
| | - Sonya Kolman
- Department of Pharmacy, Nelson Mandela Children Hospital, Johannesburg, South Africa
| | - Verónica Delgado
- Head of Neonatal Intensive Care, Hospital de los Valles, Quito, Ecuador
| | - Veronica Guzman
- Pontificia Universidad Catolica del Ecuador, Hospital Metropolitano Quito, Quito, Ecuador
| | - Mohamed Abdellatif
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Luis Monterrosa
- Department of Pediatrics, Division of Neonatology, Saint John Regional Hospital, Saint John, Canada
| | | | - Khalid Yunis
- Division of Neonatology, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Nicole Le Saux
- Division of Infectious Disease, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Valentina Leonardi
- Division of Neonatology and NICU, Careggi Univerisity Hospital, Florence, Italy
| | | | | | - Hidehiko Nakanishi
- Research and Development Center for New Medical Frontiers, Department of Advanced Medicine, Division of Neonatal Intensive Care Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Michal Meir
- Division of Pediatric Infectious Diseases, The Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Paolo Manzoni
- Division of Pediatrics and Neonatology, Degli Infermi Hospital, Biella, Italy
| | | | - Angela Hoyos
- Division of Neonatology, Clínica del Country / Clínica La Colina, Bogotá, Colombia
| | | | | | - Alexandra K. Medoro
- The Ohio State University College of Medicine, Columbus, OH, USA
- Department of Pediatrics, Divisions of Neonatology and Pediatric Infectious Diseases, Nationwide Children's Hospital, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Pablo J. Sánchez
- The Ohio State University College of Medicine, Columbus, OH, USA
- Department of Pediatrics, Divisions of Neonatology and Pediatric Infectious Diseases, Nationwide Children's Hospital, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Corresponding author at: Divisions of Neonatology and Pediatric Infectious Diseases, Nationwide Children's Hospital - The Ohio State University College of Medicine, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, RB3, WB5245, Columbus, Ohio 43205-2664, United States.
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Dayie NTKD, Osei MM, Opintan JA, Tetteh-Quarcoo PB, Kotey FCN, Ahenkorah J, Adutwum-Ofosu KK, Egyir B, Donkor ES. Nasopharyngeal Carriage and Antimicrobial Susceptibility Profile of Staphylococcus aureus among Children under Five Years in Accra. Pathogens 2021; 10:136. [PMID: 33572983 PMCID: PMC7912391 DOI: 10.3390/pathogens10020136] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/16/2021] [Accepted: 01/26/2021] [Indexed: 01/31/2023] Open
Abstract
This cross-sectional study investigated the Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) nasopharyngeal carriage epidemiology in Accra approximately five years post-pneumococcal conjugate vaccines introduction in the country. Archived nasopharyngeal swabs collected from 410 children aged under five years old were bacteriologically cultured. The resultant S. aureus isolates were subjected to antimicrobial susceptibility testing and screening for carriage of the mecA and LukF-PV (pvl) genes, following standard procedures. The data obtained were analyzed with Statistical Products and Services Solutions (SPSS) using descriptive statistics and Chi square tests of associations. The isolated bacteria decreased across coagulase-negative Staphylococci (47.3%, n = 194), S. aureus (23.2%, n = 95), Diphtheroids (5.4%, n = 22), Micrococcus species (3.7%, n = 15), Klebsiella pneumoniae (3.2%, n = 13), Moraxella species and Citrobacter species (1.5% each, n = 6), Escherichia coli, Enterobacter species, and Pseudomonas species (0.9% each, n = 2). The MRSA carriage prevalence was 0.49% (n = 2). Individuals aged 37-48 months recorded the highest proportion of S. aureus carriage (32.6%, 31/95). Resistance of S. aureus to the antibiotics tested were penicillin G (97.9%, n = 93), amoxiclav (20%, n = 19), tetracycline (18.9%, n = 18), erythromycin (5.3%, n = 5), ciprofloxacin (2.1%, n = 2), gentamicin (1.1%, n = 1), cotrimoxazole, clindamycin, linezolid, and teicoplanin (0% each). No inducible clindamycin resistance was observed for the erythromycin-resistant isolates. Three (3.2%) of the isolates were multidrug resistant, of which 66.7% (2/3) were MRSA. The pvl gene was associated with 59.14% (55/93) of the methicillin-sensitive S. aureus (MSSA) isolates, but was not detected among any of the MRSA isolates.
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Affiliation(s)
- Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236 Accra, Ghana; (M.-M.O.); (J.A.O.); (P.B.T.-Q.); (F.C.N.K.); (E.S.D.)
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236 Accra, Ghana; (M.-M.O.); (J.A.O.); (P.B.T.-Q.); (F.C.N.K.); (E.S.D.)
- FleRhoLife Research Consult, P.O. Box TS 853 Accra, Ghana
| | - Japheth A. Opintan
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236 Accra, Ghana; (M.-M.O.); (J.A.O.); (P.B.T.-Q.); (F.C.N.K.); (E.S.D.)
| | - Patience B. Tetteh-Quarcoo
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236 Accra, Ghana; (M.-M.O.); (J.A.O.); (P.B.T.-Q.); (F.C.N.K.); (E.S.D.)
| | - Fleischer C. N. Kotey
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236 Accra, Ghana; (M.-M.O.); (J.A.O.); (P.B.T.-Q.); (F.C.N.K.); (E.S.D.)
- FleRhoLife Research Consult, P.O. Box TS 853 Accra, Ghana
| | - John Ahenkorah
- Department of Anatomy, University of Ghana Medical School, P.O. Box 4236 Accra, Ghana; (J.A.); (K.K.A.-O.)
| | - Kevin Kofi Adutwum-Ofosu
- Department of Anatomy, University of Ghana Medical School, P.O. Box 4236 Accra, Ghana; (J.A.); (K.K.A.-O.)
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581 Accra, Ghana;
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, P.O. Box KB 4236 Accra, Ghana; (M.-M.O.); (J.A.O.); (P.B.T.-Q.); (F.C.N.K.); (E.S.D.)
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Donkor ES, Kotey FCN. Methicillin-Resistant Staphylococcus aureus in the Oral Cavity: Implications for Antibiotic Prophylaxis and Surveillance. Infect Dis (Lond) 2020; 13:1178633720976581. [PMID: 33402829 PMCID: PMC7739134 DOI: 10.1177/1178633720976581] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/03/2020] [Indexed: 02/06/2023] Open
Abstract
The oral cavity harbors a multitude of commensal flora, which may constitute a repository of antibiotic resistance determinants. In the oral cavity, bacteria form biofilms, and this facilitates the acquisition of antibiotic resistance genes through horizontal gene transfer. Recent reports indicate high methicillin-resistant Staphylococcus aureus (MRSA) carriage rates in the oral cavity. Establishment of MRSA in the mouth could be enhanced by the wide usage of antibiotic prophylaxis among at-risk dental procedure candidates. These changes in MRSA epidemiology have important implications for MRSA preventive strategies, clinical practice, as well as the methodological approaches to carriage studies of the organism.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Fleischer CN Kotey
- Department of Medical Microbiology, College of Health Sciences, University of Ghana, Accra, Ghana
- FleRhoLife Research Consult, Teshie, Accra, Ghana
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Van Rooij FB, Bos HMW, Gerrits T, Hiadzi RA, Donkor ES. The relationship between stigmatisation and quality of life in Ghanaian women and men with fertility problems: mediating role of coping strategies. Facts Views Vis Obgyn 2020; 12:257-264. [PMID: 33575674 PMCID: PMC7863692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Fertility problems may have a devastating impact on the people involved. Specifically, in highly pronatalist settings like Ghana, the personal and social consequences are high. This study focused on the relationship between stigmatisation because of fertility problems and quality of life among Ghanaian women and men, and the possible mediating role of coping strategies. METHODS Participants (38 women, 11 men) were recruited with the help of a patient organisation and a hospital in Accra. Standardised instruments were used to measure the stigmatisation of having fertility problems, fertility quality of life and coping with fertility problems. Partial Pearson r correlations were conducted, followed by bootstrapped mediation analyses (PROCESS macro). RESULTS Stigmatisation was negatively correlated with fertility quality of life, and fertility quality of life was negatively correlated with active-avoidance coping. Active avoidance coping partially mediated the relationship between being stigmatised because of fertility problems and fertility quality of life. CONCLUSIONS Professionals working with people with fertility problems should pay more attention to how people are coping with experiences of stigmatisation.
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Affiliation(s)
- FB Van Rooij
- Research Institute of Child Development and Education, University of Amsterdam, PO Box 15780, 1001 NG, Amsterdam,
The Netherlands
| | - HMW Bos
- Research Institute of Child Development and Education, University of Amsterdam, PO Box 15780, 1001 NG, Amsterdam,
The Netherlands
| | - T Gerrits
- Faculty of Social and Behavioural Sciences, University of Amsterdam, PO Box 15509, 1001 NA Amsterdam, The Netherlands
| | - RA Hiadzi
- Department of Sociology, University of Ghana, PO.Box LG 65,Legon, Ghana
| | - ES Donkor
- School of Nursing and Midwifery, University of Health and Allied Sciences, PMB 31 Ho, Volta Region, Ghana
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Donkor ES, S. Anyen NE, Akumwena A. Making a Case for Infection Control at Public Places of Convenience in Accra, Ghana. Environ Health Insights 2020; 14:1178630220938414. [PMID: 32704231 PMCID: PMC7361476 DOI: 10.1177/1178630220938414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/02/2020] [Indexed: 06/11/2023]
Abstract
In Ghana, environmental hygiene remains a major problem and infection control measures are hardly practised, particularly outside of the hospital. To provide evidence for infection control measures at public places of convenience in Accra (capital city of Ghana), this study was performed. The aim of the study was to evaluate microbial contamination of door handles at public places of convenience in Accra and assess the public health risk. A total of 183 swab specimens were collected aseptically from door handles of public places of convenience of shops, schools, hospitals, lorry stations, churches, and markets. The samples were cultured on bacteriological media, and the isolated organisms were identified. The most prevalent bacterial agent isolated was Bacillus spp. (55.7%), followed by Staphylococcus aureus (20.2%), coagulase-negative staphylococcus spp. (17.1%), Citrobacter freundii (6.0%), Citrobacter koseri (4.4%), and Salmonella Paratyphi A (3.8%). Although in low prevalence, a wide range of enteric bacteria were isolated from door handles, accounting for 12 of the 16 isolated organisms. In conclusion, door handles of places of convenience in Accra harbour several pathogenic microorganisms, especially enteric organisms. This study highlights the need for proper disinfection of door handles of places of convenience in Accra as well as handwashing after visiting such places.
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Affiliation(s)
- Eric S Donkor
- Eric S Donkor, Department of Medical Microbiology, University of Ghana Medical School, Red Building Room 81, Korle Bu, P. O. Box 4236, Accra, Ghana. ;
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Abstract
Food-borne disease is a widespread and escalating public health problem globally. About a quarter of the microorganisms isolated from cockroaches are food-borne pathogens including Escherichia coli O157:H7, Staphylococcus aureus, Bacillus cereus, Shigella dysenteriae, Salmonella enterica subsp. enterica serovar Typhi, Rotavirus, Aspergillus fumigatus, and Cryptosporidium parvum. Thus, cockroaches could be an important reservoir and mechanical vector of food-borne pathogens. Generally, the role of cockroaches in human infections is poorly understood and has been an issue of debate for several years. This article aims to elucidate the possible role of cockroaches in food-borne infections by reviewing the relevant research publications.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, University of Ghana, Accra, Ghana
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Appiah VA, Pesewu GA, Kotey FCN, Boakye AN, Duodu S, Tette EMA, Nyarko MY, Donkor ES. Staphylococcus aureus Nasal Colonization among Children with Sickle Cell Disease at the Children's Hospital, Accra: Prevalence, Risk Factors, and Antibiotic Resistance. Pathogens 2020; 9:pathogens9050329. [PMID: 32354004 PMCID: PMC7280972 DOI: 10.3390/pathogens9050329] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to investigate S. aureus carriage among children with sickle cell disease (SCD), including the prevalence, risk factors, and antibiotic resistance. The study was cross-sectional, and involved 120 children with SCD recruited at the Princess Marie Louise Children’s Hospital (PML) in Accra and 100 apparently healthy children from environs of the hospital. Nasal swab samples were collected from the study participants and cultured for bacteria. Confirmation of S. aureus and methicillin-resistant Staphylococcus aureus (MRSA) isolates were done using the tube coagulase test and mecA polymerase chain reaction, respectively. All the S. aureus isolates were tested against standard antimicrobial agents using the Kirby-Bauer method. A structured questionnaire was used to obtain the socio-demographic and clinical data of the study participants. Binary logistic regression was used to identify determinants of S. aureus and MRSA carriage among the study participants. The nasal carriage prevalence of S. aureus was 33.3% (n = 40) and 10% (n = 10) among the participants of the SCD and control groups, respectively. As regards MRSA nasal carriage prevalence, the respective values were 3.33% (n = 4) and 0.00% (n = 0). SCD was significantly associated with S. aureus colonization (p < 0.0001, OR = 4.045), but not MRSA colonization (p = 0.128). In the SCD group, the significant predictors of S. aureus carriage were increasing age (p = 0.003; OR = 1.275) and living in self-contained apartments (p = 0.033; OR = 3.632), whereas male gender (p = 0.018; OR = 0.344) and the practice of self-medication (p = 0.039; OR = 0.233) were protective of S. aureus carriage. In the control group, a history of hospitalization in the past year was a risk factor for the carriage of S. aureus (p = 0.048; OR = 14.333). Among the participants of the SCD and control groups, respectively, the resistance prevalence recorded by S. aureus against the various antibiotics investigated were penicillin (100% each), cotrimoxazole (27.5% vs. 20%), tetracycline (25% vs. 50%), rifampicin (82.5% vs. 50%), erythromycin (30% vs. 20%), clindamycin (32.5% vs. 50%), gentamicin (7.5% vs. 20%), cefoxitin (27.5% vs. 20%), linezolid (30% vs. 40%), and fusidic acid (95% vs. 80%). The proportion of S. aureus isolates that were multidrug resistant (MDR) was 92.5% (37/40) in the SCD group and 100% (10/10) in the control group.
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Affiliation(s)
- Vera A. Appiah
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - George A. Pesewu
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - Fleischer C. N. Kotey
- FleRhoLife Research Consult, Teshie P. O. Box TS 853, Accra, Ghana
- Department of Medical Microbiology, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
| | - Alahaman Nana Boakye
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
- FleRhoLife Research Consult, Teshie P. O. Box TS 853, Accra, Ghana
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon P. O. Box LG 54, Accra, Ghana
| | - Edem M. A. Tette
- Department of Community Health, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
| | - Mame Y. Nyarko
- Princess Marie Louise Children’s Hospital, Accra P. O. Box GP 122, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra P. O. Box 4236, Ghana
- Correspondence: or ; Tel.: +233-553-527-140
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Codjoe FS, Brown CA, Smith TJ, Miller K, Donkor ES. Genetic relatedness in carbapenem-resistant isolates from clinical specimens in Ghana using ERIC-PCR technique. PLoS One 2019; 14:e0222168. [PMID: 31513633 PMCID: PMC6742460 DOI: 10.1371/journal.pone.0222168] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/19/2019] [Indexed: 11/19/2022] Open
Abstract
AIM Enterobacterial repetitive intergenic consensus (ERIC) sequence analysis is a powerful tool for epidemiological analysis of bacterial species. This study aimed to determine the genetic relatedness or variability in carbapenem-resistant isolates by species using this technique. METHODS A total of 111 non-duplicated carbapenem-resistant (CR) Gram-negative bacilli isolates from a three-year collection period (2012-2014) were investigated by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) in four selected hospital laboratories in Ghana. The isolates were also screened for carbapenemase and extended spectrum β-lactamase genes by PCR. RESULTS A proportion of 23.4% (26/111) of the genomic DNA extracts were carriers of PCR-positive carbapenemase genes, including 14.4% blaNDM-1, 7.2% blaVIM-1 and 1.8% blaOXA-48. The highest prevalence of carbapenemase genes was from non-fermenters, Acinetobacter baumannii and Pseudomonas aeruginosa. For the ESBL genes tested, 96.4% (107/111) of the CR isolates co-harboured both TEM-1 and SHV-1 genes. The ERIC-PCR gel analysis exhibited 1 to 8 bands ranging from 50 to 800 bp. Band patterns of 93 complex dissimilarities were visually distinguished from the 111 CR isolates studied, while the remaining 18 showed band similarities in pairs. CONCLUSION Overall, ERIC-PCR fingerprints have shown a high level of diversity among the species of Gram-negative bacterial pathogens and specimen collection sites in this study. ERIC-PCR optimisation assays may serve as a suitable genotyping tool for the assessment of genetic diversity or close relatedness of isolates that are found in clinical settings.
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Affiliation(s)
- Francis S. Codjoe
- Department of Medical Laboratory Sciences, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, England, United Kingdom
| | - Charles A. Brown
- Department of Medical Laboratory Sciences, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | - Thomas J. Smith
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, England, United Kingdom
| | - Keith Miller
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, England, United Kingdom
- * E-mail: (KM); (ESD)
| | - Eric S. Donkor
- Department of Medical Microbiology, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- * E-mail: (KM); (ESD)
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Dayie NTKD, Tettey EY, Newman MJ, Bannerman E, Donkor ES, Labi AK, Slotved HC. Pneumococcal carriage among children under five in Accra, Ghana, five years after the introduction of pneumococcal conjugate vaccine. BMC Pediatr 2019; 19:316. [PMID: 31488088 PMCID: PMC6727402 DOI: 10.1186/s12887-019-1690-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/26/2019] [Indexed: 12/03/2022] Open
Abstract
Background The study objective was to determine the carriage and serotype distribution of Streptococcus pneumoniae among children in Accra, Ghana, five years after the introduction of the pneumococcal conjugate vaccine (PCV-13) in 2012. Methods Nasopharyngeal swab samples were collected from 410 children below 5 years of age in Accra, Ghana, from September to December, 2016. Pneumococcal isolates were identified by optochin sensitivity and bile solubility. Serotyping was performed using the latex agglutination kit and Quellung reaction. The isolates were furthermore tested for antimicrobial susceptibility for different antimicrobials, including penicillin (PEN). Twelve isolates including seven non-typeable (NT) isolates were characterized using whole-genome sequencing analysis (WGS). Results The overall carriage prevalence was found to be 54% (95% CI, 49–59%), and 20% (95% CI, 49–59%) of the children were carrying PCV-13 included serotypes, while 37% (95% CI, 33–42%) of the children were carrying non-PCV-13 serotypes. Based on the serotype distribution, 33% of all observed serotypes were included in PCV-13 while 66% were non-PCV-13 serotypes. The dominating non-PCV-13 serotypes were 23B, 16F, and 11A followed by PCV-13 serotypes 23F and 19F. The PCV-13 covers the majority of resistant isolates in Accra. A proportion of 22.3% of the isolates showed intermediate resistance to penicillin G, while only one isolate showed full resistance. Forty-five isolates (20.5%) were defined as multidrug-resistant (MDR) as they were intermediate/resistant to three or more classes of antimicrobials. Of the seven NT isolates characterized by WGS, four showed highest match to genotype 38, while the remaining three showed highest match to genotype 14. Four MDR serotype 19A isolates were found to be MLST 320. Conclusion PCV-13 introduced in Ghana did not eliminate PCV-13 covered serotypes, and the carriage rate of 54% in this study is similar to carriage studies from pre PCV-13 period. However, the penicillin non-susceptible isolates have been reduced from 45% of carriage isolates before PCV-13 introduction to 22.3% of the isolates in this study. Continuous monitoring of serotype distribution is important, and in addition, an evaluation of an alternative vaccination schedule from 3 + 0 to 2 + 1 will be important to consider. Electronic supplementary material The online version of this article (10.1186/s12887-019-1690-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicholas T K D Dayie
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Elizabeth Y Tettey
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Mercy J Newman
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Elizabeth Bannerman
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Eric S Donkor
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Appiah-Korang Labi
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen, Denmark.
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Donkor ES, Horlortu PZ, Dayie NTKD, Obeng-Nkrumah N, Labi AK. Community acquired urinary tract infections among adults in Accra, Ghana. Infect Drug Resist 2019; 12:2059-2067. [PMID: 31372013 PMCID: PMC6628945 DOI: 10.2147/idr.s204880] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/23/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Urinary tract infection (UTI) is one of the most common bacterial infectious diseases encountered in clinical practice, and accounts for significant morbidity and high medical costs. To reduce its public health burden, there is the need for local research data to address aspects of prevention and management of UTI. The aim of this study was to investigate community-acquired UTI among adults in Accra, Ghana, including the risk factors, etiological agents, and antibiotic resistance. Methods: This was a cross-sectional study involving 307 patients clinically diagnosed with UTI at the Korle Bu and Mamprobi polyclinics in Accra. Urine specimens were collected from the study participants and analyzed by culture, microscopy, and dipstick. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antibiotics by the Kirby Bauer method. Multidrug resistant Enterobacteriaceae isolates were screened for Extended Spectrum β-lactamase (ESBL) production by the double disc method, and isolates that tested positive were analyzed by Polymerase Chain Reaction for ESBL genes. Demographic information and clinical history of study participants were collected. Results: Based on the criteria for laboratory confirmed UTI, 31 (10.1%) of the 307 specimens were positive and the main risk factor of UTI among the study participants was pregnancy (P=0.02, OR=2.43). The most common uropathogen isolated was Escherichia coli (48.9%), followed by Klebseilla sp. (16.1%). Prevalence of resistance was highest for Piperacillin (87.1%) and Amoxicillin+Clavulanic Acid (87.1%) and lowest for Amikacin (12.9%). Prevalence of multidrug resistance among the uropathogens was 80.1% (25) and the most common ESBL gene detected was CTX-M-15. Conclusion: Pregnant women constitute the key risk population of UTI in Accra, while Amikacin remains a suitable drug for the treatment of febrile UTI. The high prevalence of multidrug resistance among the uropathogens highlights the need for surveillance of antimicrobial resistance among these pathogens.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Prince Z Horlortu
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Nicholas TKD Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
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Codjoe FS, Donkor ES, Smith TJ, Miller K. Phenotypic and Genotypic Characterization of Carbapenem-Resistant Gram-Negative Bacilli Pathogens from Hospitals in Ghana. Microb Drug Resist 2019; 25:1449-1457. [PMID: 31237486 DOI: 10.1089/mdr.2018.0278] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In Ghana, surveillance efforts on antibiotic resistance so far have not covered carbapenem resistance. In this study, our aim was to apply phenotypic and genotypic methods to identify and characterize carbapenem-resistant (CR) Gram-negative bacteria from the hospital environment in Ghana. A collection of 3840 isolates of Gram-negative bacilli infections from various clinical specimens was screened for carbapenem resistance by disc diffusion for imipenem, meropenem, and doripenem. Minimum Inhibitory Concentration (MIC) of the CR isolates was determined by E-test for the three carbapenems. All the CR isolates were further screened for carbapenemase activity by modified Hodge and boronic acid disc synergy tests. The CR isolates were investigated for the presence of carbapenemase and extended-spectrum beta-lactamase genes by PCR and confirmed by sequencing. The overall prevalence of CR isolates was 2.9% (111/3840). Based on the disc diffusion test, prevalence of resistance to carbapenems were doripenem (75%), imipenem (66.7%), and meropenem (58%). The highest measurable MIC levels (≥32 μg/mL) were observed in 56.8% of CR isolates with the nonfermenters, Pseudomonas aeruginosa (24.3%) and Acinetobacter species (18.9%), disproportionately represented. Phenotypic identification of carbapenamase activity occurred in 18.9% of the CR isolates by the modified Hodge test and 2.7% by Boronic acid disc synergy test; 21.6% exhibited carbapenemase production by both methods. All the CR isolates carried ESBL genes (blaTEM and blaSHV), whereas 23.4% were carriers of carbapenemase genes, of which 14.4% were blaNDM-1, 7.2% blaVIM-1, and 1.8% blaOXA-48. Phylogenetically, the CR isolates were diverse and showed limited relatedness to isolates from other geographical regions.
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Affiliation(s)
- Francis S Codjoe
- Department of Medical Laboratory Sciences, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.,Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Eric S Donkor
- Department of Medical Microbiology, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Thomas J Smith
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Keith Miller
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
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Affiliation(s)
- Eric S. Donkor
- Department of Medical Microbiology, University of Ghana, Accra, Ghana
| | | | - Edem M. A. Tette
- Department of Community Health, University of Ghana, Accra, Ghana
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Donkor ES, Codjoe FS. Methicillin Resistant Staphylococcus aureus and Extended Spectrum Beta-lactamase Producing Enterobacteriaceae: A Therapeutic Challenge in the 21st Century. Open Microbiol J 2019. [DOI: 10.2174/1874285801913010094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Antimicrobial resistance is one of the greatest global threats to human health in recent times and it limits the achievement of several of the Sustainable Development Goals. Methicillin-ResistantStaphylococcus aureus(MRSA) and Extended-Spectrum Beta-Lactamase (ESBL) producingEnterobacteriaceaeare among the most important multidrug resistant bacterial pathogens. MRSA and ESBL-producingEnterobacteriaceaehave evolved significantly over the last few decades with important clinical and epidemiological implications. Given the slow progress of development of new antibiotics in recent times, it is likely that these multidrug resistant pathogens will have a greater impact on public health in the 21stCentury, unless other effective control measures are instituted. Effective infection control strategies coupled with antibiotic stewardship programs are required to limit the spread and burden of MRSA and ESBL-producingEnterobacteriacae.
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Donkor ES, Kotey FCN, Dayie NTKD, Duodu S, Tetteh-Quarcoo PB, Osei MM, Tette EMA. Colonization of HIV-Infected Children with Methicillin-Resistant Staphylococcus aureus. Pathogens 2019; 8:E35. [PMID: 30884909 PMCID: PMC6470964 DOI: 10.3390/pathogens8010035] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/17/2019] [Accepted: 02/21/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) poses a public health threat owing to its extensive resistance to antibiotics, association with persistent outbreaks, and markedly increased healthcare costs. Moreover, HIV-infected individuals are at a greater risk for colonization with MRSA, and may act as reservoirs for subsequent transmission to other individuals. In Ghana, little is known about MRSA in relation to at-risk populations, such as HIV-infected children. The aim of this study was to investigate nasal carriage of S. aureus and MRSA among HIV-infected children in Accra, including the prevalence, risk factors and antibiotic resistance. METHODOLOGY The study was cross-sectional, and involved 107 children with HIV infection and an equal number of sex- and age group- matched apparently healthy controls recruited from the Princess Marie Louis Children's Hospital in Accra. Nasal swab specimens were collected from the study participants and cultured for bacteria. S. aureus isolates were confirmed by the coagulase test while MRSA was confirmed by PCR of the mecA gene. Antimicrobial susceptibility testing of S. aureus isolates was done by the Kirby Bauer method. A structured questionnaire was used to collect data on demographic, household and clinical features of the study participants. A logistic regression analysis was performed to identify determinants of S. aureus and MRSA carriage among participants of both study groups. RESULTS The carriage prevalence of S. aureus and MRSA were 44.9% (48) and 5.6% (6), respectively, among the HIV-infected individuals, and the corresponding values within the control group were 23.4% (25) and 0.9% (1). There was a significant association between HIV infection and S. aureus colonization (p < 0.001), but not MRSA colonization (p = 0.055). The main predictor of S. aureus colonization in both study groups was absence of colonization with coagulase negative staphylococcus (p < 0.001). Furthermore, the main predictor of MRSA colonization was regular hand washing with soap (p = 0.043); this was observed among HIV-infected individuals but not the control group. The proportion of S. aureus isolates that were multidrug resistant was 62.3% (33/53) in the HIV-infected group and 80% (20/25) in the control group (p = 0.192). CONCLUSIONS HIV infection is a risk factor for nasal colonization of S. aureus among children in Accra but may not be for MRSA. Both the HIV-infected and uninfected children are reservoirs of multidrug resistant S. aureus. Demographic, household and clinical features appear to have little or no relationship with S. aureus and MRSA colonization in the study children.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
| | - Fleischer C N Kotey
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
- FleRhoLife Research Consult, P. O. Box TS 853, Teshie, Accra, Ghana.
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
| | - Patience B Tetteh-Quarcoo
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Edem M A Tette
- Department of Community Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
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Dayie NTKD, Baffuor-Asare M, Labi AK, Obeng-Nkrumah N, Olayemi E, Lartey M, Slotved HC, Donkor ES. Epidemiology of Pneumococcal Carriage among HIV-Infected Individuals in the Conjugate Vaccine Era: A Study in Southern Ghana. Biomed Res Int 2019; 2019:3427174. [PMID: 30895191 PMCID: PMC6393904 DOI: 10.1155/2019/3427174] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 10/10/2018] [Accepted: 01/20/2019] [Indexed: 12/28/2022]
Abstract
Carriage of pneumococcus is considered as the precursor for development of pneumococcal disease. In sub-Saharan Africa, very little research has been done on the pneumococcus in relation to people with HIV infection in the era of pneumococcal conjugate vaccines. This study investigated pneumococcal carriage among HIV/AIDS patients in southern Ghana to determine the prevalence, risk factors, serotypes and antibiotic resistance of the organism. This was a cross sectional study involving 245 HIV/AIDS patients recruited from Korle Bu Teaching Hospital and Princess Marie Louis Hospital in Accra from November 2016 to March 2017. Epidemiological data on demographic, household and clinical features of the study participants were collected. Nasopharyngeal (NP) swabs were also collected from the study participants and cultured for Streptococcus pneumoniae; the isolates were serotyped by latex agglutination and Quellung reaction. Antimicrobial disc susceptibility was performed on the isolates, and antibiotics tested included tetracycline, erythromycin, cotrimoxazole, levofloxacin, oxacillin and ceftriaxone. Prevalence of pneumococcal carriage among the study participants was 11% (95% CI: 7.4 to 15.6); carriage among children and adults was 25% (95% CI: 14% to 38.9%) and 7.3% (95% CI: 4% to 11.9%) respectively. School attendance (p=0.001) and history of pneumococcal disease in the past year (p=0.001) were significantly associated with pneumococcal carriage. The most prevalent pneumococcal serotypes carried by the study participants were 19A (15.4%) and 23F (15.4%). Serotype coverage of the various pneumococcal vaccines were PCV10 (23.1%), PCV13 (42.3%) and PPV23 (50%). The prevalence of pneumococcal multidrug resistance was 18.5%. In conclusion, pneumococcal carriage among HIV-infected children was three-fold higher compared to carriage among HIV-infected adults. Pneumococcal carriage among both HIV-infected children and adults in the study area tends to be characterized by a predominance of non-vaccine serotypes and a considerable level of multidrug resistance.
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Affiliation(s)
- Nicholas TKD Dayie
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Michael Baffuor-Asare
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | | | - Noah Obeng-Nkrumah
- Dept. of Medical Laboratory Science, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Edeghonghon Olayemi
- Dept. of Haematology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Margaret Lartey
- Dept. of Medicine, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | - Eric S. Donkor
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
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Antwi-Boasiako C, Dankwah GB, Aryee R, Hayfron-Benjamin C, Donkor ES, Campbell AD. Oxidative Profile of Patients with Sickle Cell Disease. Med Sci (Basel) 2019; 7:medsci7020017. [PMID: 30691006 PMCID: PMC6410293 DOI: 10.3390/medsci7020017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/09/2019] [Accepted: 01/18/2019] [Indexed: 01/29/2023] Open
Abstract
Oxidative stress plays a very significant role in the pathophysiology of sickle cell disease (SCD) and associated complications. Oxidative stress, which is often experienced by SCD patients as a result of continuous production of reactive oxygen species (ROS), may lead to endothelial dysfunction and acute inflammation. Antioxidant enzymes, such as superoxide dismutase (SOD) and catalase (CAT), often play a protective role. The current study aimed at determining the oxidative profile of persons with SCD at a tertiary hospital in Ghana. This was a case-control study involving 90 patients with SCD (34 HbSS patients at steady state, 30 HbSC at steady state, 15 HbSS with vaso-occlusive crisis, 11 HbSC with vaso-occlusive crisis), and 50 HbAA control group. Whole blood samples were collected from the study participants and analyzed for full blood counts. The blood samples were assayed for SOD and CAT as a measure of antioxidant defense, while lipid peroxidation was quantified as malondialdehyde (MDA). The results showed that the levels of SOD and CAT were significantly lower in SCD patients as compared to the control group. Patients with HbSS vaso-occlusive crisis had the lowest levels of SOD and CAT. The difference in SOD levels between HbSS at steady state and HbSC with vaso-occlusive crisis was, however, not significant (p = 0.228). The MDA level was significantly higher in SCD patients compared to the control group. This study concludes that the levels of various antioxidant enzymes (erythrocyte SOD and erythrocyte CAT) and oxidative marker (MDA) and are altered in SCD patients.
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Affiliation(s)
- Charles Antwi-Boasiako
- Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Gifty B Dankwah
- Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Robert Aryee
- Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Charles Hayfron-Benjamin
- Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
- Department of Anaesthesia, School of Medicine and Dentistry, University of Ghana, Accra +233, Ghana.
| | - Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Andrew D Campbell
- Center for Cancer and Blood Disorders Children's National Medical Center George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA.
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Donkor ES. Nosocomial Pathogens: An In-Depth Analysis of the Vectorial Potential of Cockroaches. Trop Med Infect Dis 2019; 4:E14. [PMID: 30658473 PMCID: PMC6473430 DOI: 10.3390/tropicalmed4010014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/10/2019] [Accepted: 01/15/2019] [Indexed: 12/12/2022] Open
Abstract
Nosocomial or healthcare-associated infections are regarded as the most frequent adverse event that threatens patients' safety and has serious economic and social consequences. Cockroach infestation is common in many hospitals, especially in the developing world. Common nosocomial pathogens isolated from cockroaches include Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae. Cockroaches also harbor epidemiologically significant antibiotic-resistant organisms, such as carbapenem-resistant Enterobacteriaceae, which complicate nosocomial infections. Therefore, cockroaches constitute an important vector for nosocomial pathogens, and there should be zero tolerance for their presence in healthcare facilities. This paper aims to elucidate the possible role of cockroaches in nosocomial infections by reviewing the relevant research publications.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, University of Ghana, Accra, Ghana.
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Dayie NTKD, Tetteh-Ocloo G, Labi AK, Olayemi E, Slotved HC, Lartey M, S. Donkor E. Pneumococcal carriage among sickle cell disease patients in Accra, Ghana: Risk factors, serotypes and antibiotic resistance. PLoS One 2018; 13:e0206728. [PMID: 30408061 PMCID: PMC6224078 DOI: 10.1371/journal.pone.0206728] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/18/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Pneumococcal carriage is the precursor for development of pneumococcal disease, and is also responsible for transmission of the organism from person-to-person. Individuals with Sickle Cell Disease (SCD) are more likely to develop invasive disease with S. pneumoniae compared to their healthy counterparts and the presentation of disease in the former is usually abrupt and severe. In Africa, little is known about the pneumococcus in relation to people with SCD Sickle Cell Disease (SCD). The aim of the study was to investigate the epidemiology of pneumococcal carriage among SCD patients including the carriage prevalence, risk factors, serotypes and antibiotic resistance. METHOD This was a cross sectional study involving 402 SCD patients recruited from Korle Bu Teaching Hospital and Princess Marie Louis Hospital in Accra from October 2016 to March 2017. The study subjects included 202 children of the age groups: ≤5 years (94), >5-9 years (75), ≥10-13 years (33) and 200 adults of the age groups: 14-20 years (46), 21-40 years (112), 41-60 years (25), ≤ 61 years (17). Nasopharyngeal (NP) swabs were collected from the study participants as well as epidemiological data on demographic, household and clinical features. The NP specimens were cultured for S. pneumoniae and the isolates were serotyped by latex agglutination. Antimicrobial susceptibility tests of the isolates were done by the disc diffusion test and E-test. RESULTS Prevalence of S. pneumoniae carriage among children and adult SCD patients enrolled in the study were 79/202 (39.1%; 95% CI: 32.3 to 46.2) and 20/200 (10.0%; 95% CI: 6.2 to 15.0) respectively. Risk factors associated with pneumococcal carriage were age (OR = 1.137; 95% CI: 1.036-1.248; p = 0.007) and runny nose (OR = 5.371; 95% CI: 1.760-16.390; p = 0.003). Overall, twenty-six pneumococcal serotypes were isolated from the study participants and the predominant serotype was 6B (10.6%), followed by 23B (8.2%). Among the children, serotype coverage of the 13-valent Pneumococcal Conjugate Vaccine, which is currently used in Ghana was 32.4%. Prevalence of penicillin resistance among the pneumococcal isolates was 37.4% (37/99) and all the penicillin-resistant isolates exhibited intermediate penicillin resistance with the exception of one isolate that showed full resistance and was susceptible to ceftriaxone. Prevalence of resistance to the other antibiotics ranged from 2.5% (levofloxacin) to 85% (cotrimoxazole). Multidrug resistance occurred among 34.3% (34/99) of the pneumococcal isolates. CONCLUSION Pneumococcal carriage was four-fold higher in SCD children than adults and was characterized by predominance of non-vaccine serotypes and considerable level of multidrug resistance, though penicillin, cefotaxime and levofloxacin resistance appeared to be very low.
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Affiliation(s)
- Nicholas T. K. D. Dayie
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Georgina Tetteh-Ocloo
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | | | - Edeghonghon Olayemi
- Dept. of Haemataology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Hans-Christian Slotved
- Statens Serum Institut, Dept of Microbiological Surveillance and Research, Copenhagen, Denmark
| | - Margaret Lartey
- Dept. of Medicine, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Eric S. Donkor
- Dept. of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
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Donkor ES, Jamrozy D, Mills RO, Dankwah T, Amoo PK, Egyir B, Badoe EV, Twasam J, Bentley SD. A genomic infection control study for Staphylococcus aureus in two Ghanaian hospitals. Infect Drug Resist 2018; 11:1757-1765. [PMID: 30349333 PMCID: PMC6188180 DOI: 10.2147/idr.s167639] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Whole genome sequencing analysis (WGSA) provides the best resolution for typing of bacterial isolates and has the potential for identification of transmission pathways. The aim of the study was to apply WGSA to elucidate the possible transmission events involved in two suspected Staphylococcus aureus hospital outbreaks in Ghana and describe genomic features of the S. aureus isolates sampled in the outbreaks. Methods The study was carried out at Korle-Bu Teaching Hospital and Lekma Hospital where the suspected outbreaks occurred in 2012 and 2015, respectively. The S. aureus isolates collected from the two hospitals were from three sources including carriage, invasive disease, and the environment. Whole genome sequencing of the S. aureus isolates was performed and the sequence reads were mapped to the S. aureus reference genome of strain USA300_FPR3757. A maximum-likelihood phylogenetic tree was reconstructed. Multilocus sequence typing together with the analysis of antimicrobial resistance and virulence genes were performed by short read mapping using the SRST2. Results The S. aureus isolates belonged to diverse sequence types (STs) with ST15 and ST152 most common. All isolates carried the blaZ gene, with low prevalence of tetK and dfrG genes also observed. All isolates were mecA negative. The pvl genes were common and observed in distinct lineages that revealed diverse Sa2int phages. At Korle-Bu Teaching Hospital, the genomics data indicated several transmission events of S. aureus ST15 involving contamination of various surfaces in the pediatric emergency ward where the outbreak occurred. Conclusion The pattern of dissemination of the ST15 clone in the emergency ward of Korle-Bu Teaching Hospital highlights a basic problem with disinfection of environmental surfaces at the hospital. Diverse phage population rather than a single highly transmissible phage type likely mediates the high prevalence of pvl genes among the S. aureus isolates.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Dorota Jamrozy
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK,
| | - Richael O Mills
- Central Laboratory, Korle-Bu Teaching Hospital, Accra, Ghana.,Department of Biomedical Sciences, University of Cape Coast, Cape Coast Ghana
| | - Thomas Dankwah
- Central Laboratory, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Philip K Amoo
- Public Health Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Beverly Egyir
- Bacteriology Unit, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ebenezer V Badoe
- Department of Child Health, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | - Stephen D Bentley
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK,
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Antwi-Boasiako C, Dzudzor B, Kudzi W, Doku A, Dale CA, Sey F, Otu KH, Boatemaa GD, Ekem I, Ahenkorah J, Achel DG, Aboagye ET, Donkor ES. Association between eNOS Gene Polymorphism (T786C and VNTR) and Sickle Cell Disease Patients in Ghana. Diseases 2018; 6:E90. [PMID: 30274269 PMCID: PMC6313677 DOI: 10.3390/diseases6040090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/21/2018] [Accepted: 09/27/2018] [Indexed: 01/01/2023] Open
Abstract
Endothelial nitric oxide synthase (eNOS) variants have been found to be associated with several vascular disorders as well as the pathogenesis of sickle cell disease (SCD) complications such as vaso-occlusive crises (VOC). Studies on eNOS gene variants among SCD patients are rare in Ghana and several other African countries. The current study aimed to determine a possible association between variants of the eNOS gene (variable number of tandem repeats in intron 4 and T786C) in SCD complications among Ghanaian patients. This was a cross-sectional study involving 89 HbSS patients with complications and 46 HbSS patients without complications. Genomic DNA was extracted from leukocytes in the buffy coat and separated from collected whole blood samples of the study participants. PCR amplification, followed by restriction fragment length polymorphism (RFLP) was used to genotype T786C (rs2070744) variants. Variable number of tandem repeats (VNTR) in intron 4 was genotyped by PCR and direct electrophoresis. There was a significant difference in the genotype frequency of the T786C variant between HbSS patients with complications and those without complications (p = 0.0165). However, there was no significant difference in the VNTR intron 4 variant of the eNOS gene between patients with complications and those without complications (p > 0.05). The study shows an association between the eNOS gene variant (T786C) and complications in SCD.
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Affiliation(s)
- Charles Antwi-Boasiako
- Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Bartholomew Dzudzor
- Department of Medical Biochemistry, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - William Kudzi
- Centre for Tropical Clinical Pharmacology and Therapeutics School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Alfred Doku
- Department of Internal Medicine, School of Medicine and Dentistry, University of Ghana, Accra +233, Ghana.
| | - Campbell Andrew Dale
- Center for Cancer and Blood Disorders Children's National Medical Center George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA.
| | - Fredericka Sey
- Center for Clinical Genetics, Korle-Bu Teaching Hospital, Accra +233, Ghana.
| | - Kate Hgar Otu
- Department of Nursing and Midwifery, Greenhills School of Health Sciences, Accra +233, Ghana.
| | - Gifty Dankwah Boatemaa
- Department of Physiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Ivy Ekem
- Department of Haematology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast +233, Ghana.
| | - John Ahenkorah
- Department of Anatomy, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Daniel Gyingiri Achel
- Applied Radiation Biology Center, Radiological and Medical Sciences Research, Ghana Atomic Energy Commission, Accra +233, Ghana.
| | - Elvis Twumasi Aboagye
- Centre for Tropical Clinical Pharmacology and Therapeutics School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
| | - Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra +233, Ghana.
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Abbey M, Afagbedzi SK, Afriyie-Mensah J, Antwi-Agyei D, Atengble K, Badoe E, Batchelor J, Donkor ES, Esena R, Goka BQ, Head MG, Labi AK, Nartey E, Sagoe-Moses I, Tette EMA. Pneumonia in Ghana-a need to raise the profile. Int Health 2018; 10:4-7. [PMID: 29401244 DOI: 10.1093/inthealth/ihx062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/23/2017] [Indexed: 11/14/2022] Open
Abstract
Despite the high mortality, pneumonia retains a relatively low profile among researchers, funders and policymakers. Here we reflect on the problems and priorities of pneumonia in Ghana, briefly review the evidence base and reflect upon in-person discussions between Southampton-based authors MGH and JB and academic, clinical and policy colleagues in Ghana. The discussions took place in Accra in August 2017.
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Affiliation(s)
- Mercy Abbey
- Research and Development Division, Ghana Health Service, Accra, Ghana
| | | | - Jane Afriyie-Mensah
- Department of Medicine and Therapeutics, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | | | - Ebenezer Badoe
- Department of Child Health, University of Ghana, Accra, Ghana
| | - James Batchelor
- Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
| | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana, Accra, Ghana
| | - Reuben Esena
- School of Public Health, University of Ghana, Accra, Ghana
| | - Bamenla Q Goka
- Department of Child Health, University of Ghana, Accra, Ghana
| | - Michael G Head
- Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
| | - Appiah-Korang Labi
- Department of Medical Microbiology, Korle-Bu Teaching Hospital, AccraGhana
| | - Edmund Nartey
- Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana, Accra, Ghana
| | | | - Edem M A Tette
- Department of Community Health, School of Public Health, University of Ghana, Accra, Ghana
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Asafo-Adjei K, Mensah JE, Labi AK, Dayie NTKD, Donkor ES. Urinary Tract Infections among Bladder Outlet Obstruction Patients in Accra, Ghana: Aetiology, Antibiotic Resistance, and Risk Factors. Diseases 2018; 6:E65. [PMID: 30029549 PMCID: PMC6164110 DOI: 10.3390/diseases6030065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/05/2018] [Accepted: 07/10/2018] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to investigate urinary tract infections among patients with Bladder Outlet Obstruction (BOO) at the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana, including the prevalence, risk factors, aetiological agents and their antibiogram. Urine specimens were collected from 188 male patients presenting with BOO and cultured for bacteria. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antimicrobial agents using the Kirby Bauer method. Demographic information and the clinical history of study participants were also recorded. The prevalence of urinary tract infection among the BOO patients was 76.6% and the main risk factor identified was catheterization (p < 0.0001). A wide range of bacterial organisms was isolated from urine specimens and they were predominantly, Enterobacteriaceae; Escherichia coli was the most frequent cause of bacteriuria (33.3%), followed by Klebsiella (17.3%). Bacterial isolates were most resistant to Augmentin (97.8%) followed by tetracycline (85.8%), nalidixic acid (82.8%) and ciprofloxacin (75%) while 93.6% were multi-drug resistant. The highest susceptibility was observed with amikacin, which had a resistance prevalence of 4.4% resistance. These findings have important implications in the treatment of urinary tract infections among the BOO patients in Ghana.
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Affiliation(s)
- Karikari Asafo-Adjei
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, 00233 Accra, Ghana.
| | - James E Mensah
- Department of Surgery, School of Medicine and Dentistry, University of Ghana, 00233 Accra, Ghana.
| | - Appiah-Korang Labi
- Department of Microbiology, Korle-Bu Teaching Hospital, 00233 Accra, Ghana.
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, 00233 Accra, Ghana.
| | - Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, 00233 Accra, Ghana.
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Antwi-Boasiako C, Frimpong E, Gyan B, Kyei-Baafour E, Sey F, Dzudzor B, Abdul-Rahman M, Dankwah GB, Otu KH, Ndanu TA, Campbell AD, Ekem I, Donkor ES. Elevated Proangiogenic Markers are Associated with Vascular Complications within Ghanaian Sickle Cell Disease Patients. Med Sci (Basel) 2018; 6:E53. [PMID: 29954157 PMCID: PMC6164085 DOI: 10.3390/medsci6030053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/22/2018] [Accepted: 06/22/2018] [Indexed: 01/19/2023] Open
Abstract
: Sickle cell disease (SCD) is an inherited blood disorder that can result in vasculopathy and end organ damage. Angiogenesis has been implicated as a key contributing factor to vascular mediated tissue injury in SCD. The relative plasma levels of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF) greatly influence angiogenesis. Dysregulation of these growth factors, leading to a pro-angiogenic state in SCD patients, has been documented in the developed world but there is very little data in Africa. There is the need, therefore, for studies in Ghanaian SCD patients. The aim of this study was to assess plasma levels of Ang-1, Ang-2, and VEGF in homozygous (HbSS) SCD patients with or without complications and healthy controls (HbAA) in Ghana. The study was a case-control study involving 544 participants: 396 HbSS SCD patients and 148 HbAA healthy controls. The study was conducted at the Center for Clinical Genetics (Sickle Cell Clinic) and Accra Area Blood Centre for National Blood transfusion at the Korle-Bu Teaching Hospital, Accra, Ghana. The plasma levels of Ang-1, Ang-2, and VEGF of study participants were measured with a double sandwich enzyme-linked immunosorbent assay (ELISA) technique. Complete blood count (CBC) was measured with an autoanalyser. The mean plasma Ang-1, Ang-2, and VEGF were significantly higher in HbSS SCD patients with or without complications than healthy controls (p < 0.001). The Ang-2/Ang-1 ratio was significantly lower in the controls than the HbSS patients (p < 0.001). The Ang-2/Ang-1 ratio was higher in the HbSS patients with leg ulcers as compared with patients with other complications and healthy controls (p < 0.001). There were higher leucocyte counts in HbSS patients than healthy controls. Overall, there was elevated plasma levels of Ang-1, Ang-2, and VEGF in SCD patients. The higher Ang-2/Ang-1 plasma levels in patients with leg ulcers suggests a possible ongoing angiogenesis and response to inflammatory stimuli. The study provides a first report on plasma levels of angiopoietin-1, angiopoietin-2, and vascular endothelial growth factors in homozygous sickle cell disease patients in Ghana.
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Affiliation(s)
| | - Emmanuel Frimpong
- School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Ben Gyan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
| | - Eric Kyei-Baafour
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
| | - Fredericka Sey
- Sickle Cell Clinic, Korle-Bu Teaching Hospital, Accra, Ghana.
| | - Bartholomew Dzudzor
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
| | - Mubarak Abdul-Rahman
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
| | - Gifty B Dankwah
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
| | - Kate H Otu
- Department of Nursing and Midwifery, Greenhills School of Health Sciences, Accra, Ghana.
| | - Tom A Ndanu
- School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
| | - Andrew D Campbell
- Center for Cancer and Blood Disorder, Hematology Children's National Medical Center, George Washington School of Medicine and Health Sciences, Washington, DC 20052, USA.
| | - Ivy Ekem
- School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Eric S Donkor
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
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Abstract
Carbapenem resistance is a major and an on-going public health problem globally. It occurs mainly among Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, and may be intrinsic or mediated by transferable carbapenemase-encoding genes. This type of resistance genes are already widespread in certain parts of the world, particularly Europe, Asia and South America, while the situation in other places such as sub-Saharan Africa is not well documented. In this paper, we provide an in-depth review of carbapenem resistance providing up-to-date information on the subject.
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Affiliation(s)
- Francis S Codjoe
- Department of Medical Laboratory Sciences (Microbiology Division), School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Korle Bu KB 143 Accra, Ghana.
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK.
| | - Eric S Donkor
- Department of Medical Microbiology, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Korle Bu KB 143 Accra, Ghana.
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Donkor ES, Darkwah S, Akpalu A. Post-Stroke Bacteriuria: A Longitudinal Study among Stroke Outpatients and Inpatients at the Korle-Bu Teaching Hospital in Ghana. Med Sci (Basel) 2017; 5:medsci5020011. [PMID: 29099028 PMCID: PMC5635783 DOI: 10.3390/medsci5020011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 05/17/2017] [Accepted: 05/19/2017] [Indexed: 12/13/2022] Open
Abstract
Infections of the urinary tract constitute an important post-stroke complication but in Africa, little is known about such infections in relation to stroke patients. The aim of the study was to investigate the epidemiology of bacteriuria among stroke patients at the Korle-Bu Teaching Hospital (KBTH) in Ghana including the prevalence, incidence, risk factors and aetiological agents. This was a longitudinal study involving 55 outpatients and 16 inpatients of stroke from the physiotherapy clinic and stroke admission ward of KBTH respectively. Urine cultures for inpatient subjects were done each day until the patient was discharged. With outpatients, urine specimens were analysed every week or two for 6 months. Information on demographics and clinical history of the study participants were extracted from their clinical records. The results showed that the prevalence of bacteriuria among stroke outpatients and inpatients were 10.9% (6/55) and 18.8% (3/16) respectively (p = 0.411). Among both the outpatients and inpatients, there was one new case of bacteriuria each during the period of follow-up. Overall, 1/9 (11%) of the bacteriuria cases among the stroke patients was symptomatic. Severe stroke (OR = 17.7, p = 0.008) and pyuria (OR = 38.7, p = 0.002) were identified as predictors of bacteriuria. Escherichia coli was the most common organism implicated in bacteriuria and was susceptible to amikacin, but resistant to augmentin, ampicillin, cefuroxime, cotrimoxazole, meropenem, norfloxacin and tetracycline. Overall, bacteriuria is a common complication among both stroke inpatients and outpatients at KBTH, though it appears to be more common among the former. Stroke severity appears to be the main stroke-related determinant of bacteriuria among stroke patients. Bacteriuria among stroke patients is mainly asymptomatic and E. coli is the most important aetiological agent.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana.
| | - Samuel Darkwah
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana.
| | - Albert Akpalu
- Department of Medicine, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
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Donkor ES, Osei JA, Anim-Baidoo I, Darkwah S. Risk of Asymptomatic Bacteriuria among People with Sickle Cell Disease in Accra, Ghana. Diseases 2017; 5:diseases5010004. [PMID: 28933357 PMCID: PMC5456336 DOI: 10.3390/diseases5010004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/31/2017] [Accepted: 02/07/2017] [Indexed: 12/01/2022] Open
Abstract
Asymptomatic bacteriuria (ASB) is benign except in certain medical conditions such as pregnancy and immunosuppression. In Ghana, there are hardly any studies on urinary infections among sickle cell disease (SCD) patients, and the few studies carried out in Africa focused on pediatric SCD populations. The current study aimed to investigate the risk of ASB among SCD patients at a tertiary hospital in Ghana. This was a cross-sectional study involving 110 SCD patients and 110 age and sex matched healthy controls. Urine specimens were collected from all the study subjects and analyzed by standard microbiological methods. Demographic information were also collected from the study subjects. The overall ASB prevalence was significantly higher among SCD patients (17.2%) than among the control group (8.2%), and the relative risk was 2.11 (p = 0.0431; CI = 1.00–4.45). Being female was as a predictor of ASB among the SCD patients (OR = 14.76; CI = 11.23–18.29; p = 0.0103). The most common organism isolated from the study participants was coagulase negative Staphylococcus species (4.1%), followed by Escherichia coli (2.7%); etiology of ASB in the SCD patients was more diverse compared to healthy people. All the E. coli isolates were susceptible to amikacin, sparfloxacin and norfloxacin but resistant to ampicillin.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
| | - Jonathan A Osei
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
| | - Isaac Anim-Baidoo
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
| | - Samuel Darkwah
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
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Donkor ES, Annan JA, Badoe EV, Dayie NTKD, Labi AK, Slotved HC. Pneumococcal carriage among HIV infected children in Accra, Ghana. BMC Infect Dis 2017; 17:133. [PMID: 28178935 PMCID: PMC5299768 DOI: 10.1186/s12879-017-2224-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 01/27/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Pneumococcal carriage is the precursor for development of pneumococcal disease, and is also responsible for transmission of the organism from person-to-person. In Africa, little is known about the pneumococcus in relation to people with HIV infection. The aim of the study was to investigate the epidemiology of pneumococcal carriage among HIV infected children visiting a tertiary hospital in Ghana, including the carriage prevalence, risk factors and serotype distribution. METHOD This was a cross sectional study carried out from February to May, 2015 at the HIV Paediatric Clinic of the Korle-Bu Teaching Hospital in Accra, Ghana. One hundred and eighteen HIV infected children were recruited and nasopharyngeal (NP) swabs were collected from them. Epidemiological data on demographic, household and clinical features of the study participants were also collected. The NP specimens were cultured for Streptococcus pneumoniae and the isolates were serotyped by latex agglutination. The data of the study was analysed using STATA 11 (Strata Corp, College Station, TX, USA). RESULTS Prevalence of pneumococcal carriage among the HIV infected children was 27.1% (95% CI: 19.1 to 35.1) and the only factor significantly associated with pneumococcal carriage was the presence of respiratory symptoms (OR, 2.63; CI, 1.06-6.53; p = 0.034). The most prevalent pneumococcal serotype among the study participants was serotype 19F (24.4%), followed by 16F (22%). Serotype coverage of the 13-valent Pneumococcal Conjugate Vaccine in this study was 41.5%. Multiple carriage of pneumococcal serotypes among the positive carriage cases was 34.3%. CONCLUSION Pneumococcal carriage occurred in more than a quarter of the study population and was characterized by predominance of non-vaccine serotypes as well as a high prevalence of multiple carriage. Presence of respiratory symptoms appears to be a major determinant of pneumococcal carriage among the study population.
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Affiliation(s)
- Eric S. Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Jennifer A. Annan
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | - Ebenezer V. Badoe
- Department of Child Health, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana
| | | | - Hans-Christian Slotved
- Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
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Tette EMA, Neizer M, Nyarko MY, Sifah EK, Nartey ET, Donkor ES. Changing Patterns of Disease and Mortality at the Children's Hospital, Accra: Are Infections Rising? PLoS One 2016; 11:e0150387. [PMID: 27045667 PMCID: PMC4821618 DOI: 10.1371/journal.pone.0150387] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/12/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Millennium Development Goals (MDGs) have led to reductions in child mortality world-wide. This has, invariably, led to the changes in the epidemiology of diseases associated with child mortality. Although facility based data do not capture all deaths, they provide an opportunity to confirm diagnoses and insight into these changes which are relevant for further disease control. OBJECTIVE To identify changes in the disease pattern of children who died at the Princess Marie Louise Children's Hospital (PML) in Ghana from 2003-2013. METHODS A cross sectional review of mortality data was carried out at PML. The age, sex, duration of admission and diagnosis of consecutive patients who died at the hospital between 2003 and 2013 were reviewed. This information was entered into an Access database and analysed using Stata 11.0 software. RESULTS Altogether, 1314 deaths (3.6%) occurred out of a total of 37,012 admissions. The majority of the deaths, 1187 (90.3%), occurred in children under the age of 5 years. While deaths caused by malaria, malnutrition, HIV infection and diarrhoea decreased, deaths caused by pneumonia were rising. Suspected septicaemia and meningitis showed a fluctuating trend with only a modest decrease between 2012 and 2013. The ten leading causes of mortality among under-fives were malnutrition, 363 (30.6%); septicaemia, 301 (25.4%); pneumonia, 218 (18.4%); HIV infection, 183 (15.4%); malaria, 155 (13.1%); anaemia, 135 (11.4%); gastroenteritis/dehydration, 110 (9.3%); meningitis, 58 (4.9%); tuberculosis, 34 (2.9%) and hypoglycaemia, 27 (2.3%). For children aged 5-9 years, the leading causes of mortality were malaria, 42 (42.9%); HIV infection, 27 (27.6%); anaemia, 14 (14.3%); septicaemia, 12 (12.2%); meningitis, 10 (10.2%); malnutrition, 9 (9.2%); tuberculosis, 5 (5.1%); pneumonia, 4 (4.1%); encephalopathy, 3 (3.1%); typhoid fever, 3 (3.1%) and lymphoma, 3 (3.1%). In the adolescent age group, malaria, 8 (27.6%); anaemia, 6 (20.7%); HIV infection, 5 (17.2%); sickle cell disease, 3 (10.3%) and meningitis, 3 (10.3%) were most common. CONCLUSION There has been a decline in the under-five mortality at PML over the years; however, deaths caused by pneumonia appear to be rising. This highlights the need for better diagnostic services, wider HIV screening and clinical audits to improve outcomes in order to achieve further reductions in child mortality and maintain the gains.
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Affiliation(s)
- Edem M. A. Tette
- Department of Community Health, School of Public Health, University of Ghana, Legon, Ghana
- Princess Marie Louis Children’s Hospital, Accra, Ghana
- * E-mail:
| | | | | | - Eric K. Sifah
- Princess Marie Louis Children’s Hospital, Accra, Ghana
| | - Edmund T. Nartey
- Centre for Tropical Clinical Pharmacology and Therapeutics, School of Medicine and Dentistry, University of Ghana, Legon, Ghana
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
| | - Eric S. Donkor
- Department of Medical Microbiology, College of Health Sciences, University of Ghana, Legon, Ghana
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Donkor ES, Akumwena A, Amoo PK, Owolabi MO, Aspelund T, Gudnason V. Post-stroke bacteriuria among stroke patients attending a physiotherapy clinic in Ghana: a cross-sectional study. Ther Clin Risk Manag 2016; 12:457-62. [PMID: 27051289 PMCID: PMC4803267 DOI: 10.2147/tcrm.s90474] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Infections are known to be a major complication of stroke patients. In this study, we evaluated the risk of community-acquired bacteriuria among stroke patients, the associated factors, and the causative organisms. METHODS This was a cross-sectional study involving 70 stroke patients and 83 age- and sex-matched, apparently healthy controls. Urine specimens were collected from all the study subjects and were analyzed by standard microbiological methods. Demographic and clinical information was also collected from the study subjects. For stroke patients, the information collected also included stroke parameters, such as stroke duration, frequency, and subtype. RESULTS Bacteriuria was significantly higher among stroke patients (24.3%, n=17) than among the control group (7.2%, n=6), with a relative risk of 3.36 (confidence interval [CI], 1.40-8.01, P=0.006). Among the control group, all six bacteriuria cases were asymptomatic, whereas the 17 stroke bacteriuria cases comprised 15 cases of asymptomatic bacteriuria and two cases of symptomatic bacteriuria. Female sex (OR, 3.40; CI, 1.12-10.30; P=0.03) and presence of stroke (OR, 0.24; CI, 0.08-0.70; P=0.009) were significantly associated with bacteriuria. The etiology of bacteriuria was similar in both study groups, and coagulase-negative Staphylococcus spp. were the most predominant organisms isolated from both stroke patients (12.9%) and the control group (2.4%). CONCLUSION Stroke patients in the study region have a significantly higher risk of community-acquired bacteriuria, which in most cases is asymptomatic. Community-acquired bacteriuria in stroke patients appears to have little or no relationship with clinical parameters of stroke such as stroke subtype, duration and frequency.
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Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, College of Health Sciences, University of Ghana, Accra, Ghana; Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Amos Akumwena
- Department of Medical Microbiology, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Philip K Amoo
- Public Health Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Mayowa O Owolabi
- Department of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Thor Aspelund
- Icelandic Heart Association Research Institute, Kopavogur, Iceland; Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kopavogur, Iceland; Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland
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Damanka S, Adiku TK, Armah GE, Rodrigues O, Donkor ES, Nortey D, Asmah R. Rotavirus Infection in Children with Diarrhea at Korle-Bu Teaching Hospital, Ghana. Jpn J Infect Dis 2016; 69:331-4. [DOI: 10.7883/yoken.jjid.2014.407] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Susan Damanka
- Noguchi Memorial Institute for Medical Research, University of Ghana
| | | | - George E. Armah
- Noguchi Memorial Institute for Medical Research, University of Ghana
| | | | - Eric S. Donkor
- Department of Microbiology, University of Ghana Medical School
| | | | - Richard Asmah
- Department of Medical Laboratory Sciences, University of Ghana School of Allied Health Sciences
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