1
|
Aworh MK, Nilsson P, Egyir B, Owusu FA, Hendriksen RS. Rare serovars of non-typhoidal Salmonella enterica isolated from humans, beef cattle and abattoir environments in Nigeria. PLoS One 2024; 19:e0296971. [PMID: 38252613 PMCID: PMC10802957 DOI: 10.1371/journal.pone.0296971] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Salmonella is considered one of the most significant pathogens in public health since it is a bacterium that is frequently linked to food-borne illnesses in humans. Some Salmonella serovars are responsible for outbreaks that are connected to the consumption of animal products. Cattle are connected to humans through a shared environment and the food chain as a significant source of animal protein. In Nigeria, antimicrobial medications are easily accessible for use in food-producing animals. Abattoir environments are reservoirs of foodborne bacteria like non-typhoidal Salmonella enterica (NTS), that have become resistant to antibiotics used for prophylaxis or treatment in animals. This study investigated the prevalence and resistance patterns of Salmonella enterica serovars in abattoir employees, beef cattle and abattoir environments in Abuja and Lagos, Nigeria. METHODS A total of 448 samples were collected from healthy personnel, slaughtered cattle, and abattoir environments between May and December 2020. Using Kirby-Bauer disk diffusion method, the resistance profile of NTS isolates were determined. Multidrug resistance (MDR) was considered when NTS was resistant to ≥3 antimicrobial drug classes. We performed phenotypic and genotypic characterizations of all Salmonella isolates including serotyping. Descriptive statistics were used to analyze the data. RESULTS Twenty-seven (6%) NTS isolates were obtained. Prevalence of NTS was highest in abattoir environments (15.5%; 9/58), followed by cattle (4.8%;13/272) and abattoir employees (4.2%; 5/118). A high prevalence of resistance was observed for gentamicin (85.2%; 23/27) and tetracycline (77.8%; 21/27). Whole-genome sequencing of 22 NTS showed dissemination of aac(6')-laa (22/22), qnrB19 (1/22), fosA7 (1/22), and tetA (1/22) genes. Serovar diversity of NTS varied with source. S. Anatum, a rare serovar predominated with a prevalence of 18.2% (4/22). Chromosomal point mutations showed ParC T57S substitution in 22 NTS analyzed. Among 22 NTS, 131 mobile genetic elements (MGEs) were detected including insertion sequences (56.5%) and miniature inverted repeats (43.5%). Two integrating MGEs IS6 and IS21 were observed to carry the tetA gene + Incl-1 on the same contig in NTS originating from cattle. Rare serovars namely S. Abony and S. Stormont with MDR phenotypes recovered from cattle and abattoir environments were closely related with a pairwise distance of ≤5 SNPs. CONCLUSIONS First report of rare serovars in Nigeria with MDR phenotypes in humans, cattle, and abattoir environments. This study demonstrates the spread of resistance in the abattoir environment possibly by MGEs and emphasizes the importance of genomic surveillance. Beef cattle may be a risk to public health because they spread a variety of rare Salmonella serovars. Therefore, encouraging hand hygiene among abattoir employees while processing beef cattle will further reduce NTS colonization in this population. This requires a One Health collaborative effort among various stakeholders in human health, animal health, and environmental health.
Collapse
Affiliation(s)
- Mabel Kamweli Aworh
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
- Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria
| | - Pernille Nilsson
- Research Group for Global Capacity Building, National Food Institute, WHO Collaborating Centre (WHO CC) for Antimicrobial Resistance in Foodborne Pathogens and Genomics, FAO Reference Laboratory (FAO RL) for Antimicrobial Resistance, European Union Reference Laboratory for Antimicrobial Resistance (EURL-AR), Technical University of Denmark, Kongens Lyngby, Denmark
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Felicia Amoa Owusu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Rene S. Hendriksen
- Research Group for Global Capacity Building, National Food Institute, WHO Collaborating Centre (WHO CC) for Antimicrobial Resistance in Foodborne Pathogens and Genomics, FAO Reference Laboratory (FAO RL) for Antimicrobial Resistance, European Union Reference Laboratory for Antimicrobial Resistance (EURL-AR), Technical University of Denmark, Kongens Lyngby, Denmark
| |
Collapse
|
2
|
Amuasi GR, Dsani E, Owusu-Nyantakyi C, Owusu FA, Mohktar Q, Nilsson P, Adu B, Hendriksen RS, Egyir B. Enterococcus species: insights into antimicrobial resistance and whole-genome features of isolates recovered from livestock and raw meat in Ghana. Front Microbiol 2023; 14:1254896. [PMID: 38192291 PMCID: PMC10773571 DOI: 10.3389/fmicb.2023.1254896] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/25/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Enterococcus spp. have gradually evolved from commensals to causing life-threatening hospital-acquired infections globally due to their inherent antimicrobial resistance ability and virulence potential. Enterococcus spp. recovered from livestock and raw meat samples were characterized using antimicrobial susceptibility testing and whole-genome sequencing. Materials and methods Isolates were confirmed using the MALDI-ToF mass spectrometer, and antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion method. Whole genome sequencing was performed on isolates resistant to two or more antibiotics. Bioinformatics analysis was performed to determine sequence types, resistance and virulence gene content and evolutionary relationships between isolates from meat and livestock samples, and other enterococci genomes curated by PATRIC. eBURST analysis was used to assign genomes to clonal complexes. Results Enterococcus spp. were predominantly E. faecalis (96/236; 41%) and E. faecium (89/236; 38%). Overall, isolates showed resistance to erythromycin (78/236; 33%), tetracycline (71/236; 30%), ciprofloxacin (20/236; 8%), chloramphenicol (12/236; 5%), linezolid (7/236; 3%), ampicillin (4/236; 2%) and vancomycin (1/236, 0.4%). Resistance to two or more antimicrobial agents was detected among 17% (n = 40) Enterococcus spp. Resistance genes for streptogramins [lsa(A), lsa(E), msr(C)], aminoglycosides [aac(6')-Ii, aph(3')-III, ant(6)-Ia, aac(6')-aph(2″), str], amphenicol [cat], macrolides [erm(B), erm(T), msr(C)], tetracyclines [tet(M), tet(L), tet(S)] and lincosamides [lsa(A), lsa(E), lnu(B)] were detected among the isolates. Genes for biofilm formation, adhesins, sex pheromones, cytolysins, hyaluronidase, oxidative stress resistance, quorum-sensing and anti-phagocytic activity were also identified. Potential plasmids with replicon sequences (rep1, rep2, repUS43, repUS47, rep9a, rep9b) and other mobile genetic elements (Tn917, cn_5536_ISEnfa1, Tn6009, ISEnfa1, ISEfa10) were detected. Clinically relevant E. faecium ST32 and ST416 clones were identified in meat samples. Conclusion The occurrence of antimicrobial-resistant Enterococcus spp. in livestock and raw meat samples, carrying multiple resistance and virulence genes, including known clones associated with hospital-acquired infections, underscores the critical need for employing robust tools like whole genome sequencing. Such tools provide detailed data essential for ongoing surveillance efforts aimed at addressing the challenge of antimicrobial resistance with a focus on one health.
Collapse
Affiliation(s)
- Grebstad Rabbi Amuasi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Esther Dsani
- Veterinary Services Department, Ministry of Food and Agriculture, Accra, Ghana
| | - Christian Owusu-Nyantakyi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Felicia A. Owusu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Quaneeta Mohktar
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Pernille Nilsson
- National Food Institute, Research Group for Global Capacity Building, WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and Genomics, FAO Reference Laboratory for Antimicrobial Resistance, European Union Reference Laboratory for Antimicrobial Resistance, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Bright Adu
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Rene S. Hendriksen
- National Food Institute, Research Group for Global Capacity Building, WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and Genomics, FAO Reference Laboratory for Antimicrobial Resistance, European Union Reference Laboratory for Antimicrobial Resistance, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
3
|
Muloi DM, Jauneikaite E, Anjum MF, Essack SY, Singleton DA, Kasudi MR, Wade MJ, Egyir B, Nunn JG, Midega JT, Peacock SJ, Feasey NA, Baker KS, Zadoks RN. Exploiting genomics for antimicrobial resistance surveillance at One Health interfaces. Lancet Microbe 2023; 4:e1056-e1062. [PMID: 37977165 DOI: 10.1016/s2666-5247(23)00284-7] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 11/19/2023]
Abstract
The intersection of human, animal, and ecosystem health at One Health interfaces is recognised as being of key importance in the evolution and spread of antimicrobial resistance (AMR) and represents an important, and yet rarely realised opportunity to undertake vital AMR surveillance. A working group of international experts in pathogen genomics, AMR, and One Health convened to take part in a workshop series and online consultation focused on the opportunities and challenges facing genomic AMR surveillance in a range of settings. Here we outline the working group's discussion of the potential utility, advantages of, and barriers to, the implementation of genomic AMR surveillance at One Health interfaces and propose a series of recommendations for addressing these challenges. Embedding AMR surveillance at One Health interfaces will require the development of clear beneficial use cases, especially in low-income and middle-income countries. Evidence of directionality, risks to human and animal health, and potential trade implications were also identified by the working group as key issues. Addressing these challenges will be vital to enable genomic surveillance technology to reach its full potential for assessing the risk of transmission of AMR between the environment, animals, and humans at One Health interfaces.
Collapse
Affiliation(s)
- Dishon M Muloi
- Animal and Human Health Department, International Livestock Research Institute, Nairobi, Kenya; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Elita Jauneikaite
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, UK
| | - Muna F Anjum
- Department of Bacteriology, Animal and Plant Health Agency, New Haw, UK
| | - Sabiha Y Essack
- Antimicrobial Research Unit, University of KwaZulu-Natal, Durban, South Africa
| | - David A Singleton
- Clinical Infection, Microbiology, and Immunology, University of Liverpool, Liverpool, UK
| | - Mitchelle R Kasudi
- Animal and Human Health Department, International Livestock Research Institute, Nairobi, Kenya
| | - Matthew J Wade
- Data Analytics and Surveillance Group, UK Health Security Agency, London, UK; School of Engineering, Newcastle University, Newcastle-upon-Tyne, UK
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon-Accra, Ghana
| | - Jamie G Nunn
- Infectious Disease Challenge Area, Wellcome Trust, London, UK
| | | | | | - Nicholas A Feasey
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Malawi Liverpool Wellcome Research Programme, Chichiri, Blantyre, Malawi
| | - Kate S Baker
- Clinical Infection, Microbiology, and Immunology, University of Liverpool, Liverpool, UK; Department of Genetics, University of Cambridge, Cambridge, UK.
| | - Ruth N Zadoks
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camden, NSW, Australia; School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
| |
Collapse
|
4
|
Baker KS, Jauneikaite E, Hopkins KL, Lo SW, Sánchez-Busó L, Getino M, Howden BP, Holt KE, Musila LA, Hendriksen RS, Amoako DG, Aanensen DM, Okeke IN, Egyir B, Nunn JG, Midega JT, Feasey NA, Peacock SJ. Genomics for public health and international surveillance of antimicrobial resistance. Lancet Microbe 2023; 4:e1047-e1055. [PMID: 37977162 DOI: 10.1016/s2666-5247(23)00283-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 11/19/2023]
Abstract
Historically, epidemiological investigation and surveillance for bacterial antimicrobial resistance (AMR) has relied on low-resolution isolate-based phenotypic analyses undertaken at local and national reference laboratories. Genomic sequencing has the potential to provide a far more high-resolution picture of AMR evolution and transmission, and is already beginning to revolutionise how public health surveillance networks monitor and tackle bacterial AMR. However, the routine integration of genomics in surveillance pipelines still has considerable barriers to overcome. In 2022, a workshop series and online consultation brought together international experts in AMR and pathogen genomics to assess the status of genomic applications for AMR surveillance in a range of settings. Here we focus on discussions around the use of genomics for public health and international AMR surveillance, noting the potential advantages of, and barriers to, implementation, and proposing recommendations from the working group to help to drive the adoption of genomics in public health AMR surveillance. These recommendations include the need to build capacity for genome sequencing and analysis, harmonising and standardising surveillance systems, developing equitable data sharing and governance frameworks, and strengthening interactions and relationships among stakeholders at multiple levels.
Collapse
Affiliation(s)
- Kate S Baker
- Department for Clinical Infection, Microbiology, and Immunology, University of Liverpool, Liverpool, UK; Department of Genetics, University of Cambridge, Cambridge, UK.
| | - Elita Jauneikaite
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, UK
| | - Katie L Hopkins
- HCAI, Fungal, AMR, AMU & Sepsis Division, UK Health Security Agency, London, UK; Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, UK Health Security Agency, London, UK
| | - Stephanie W Lo
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, UK
| | - Leonor Sánchez-Busó
- Genomics and Health Area, Foundation for the Promotion of Health and Biomedical Research in the Valencian Community (FISABIO-Public Health), Valencia, Spain; CIBERESP, ISCIII, Madrid, Spain
| | - Maria Getino
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, UK
| | - Benjamin P Howden
- The Centre for Pathogen Genomics, Doherty Institute, The University of Melbourne, Melbourne, VIC, Australia
| | - Kathryn E Holt
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK; Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Lillian A Musila
- Department of Emerging Infectious Diseases, United States Army Medical Research Directorate - Africa, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya
| | - Rene S Hendriksen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Daniel G Amoako
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Department of Pathobiology, University of Guelph, Guelph, ON, Canada
| | - David M Aanensen
- Centre for Genomic Pathogen Surveillance, Nuffield Department of Medicine, University of Oxford, Big Data Institute, Oxford, UK
| | - Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon-Accra, Ghana, West Africa
| | - Jamie G Nunn
- Infectious Disease Challenge Area, Wellcome Trust, London, UK
| | | | - Nicholas A Feasey
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Malawi Liverpool Wellcome Research Programme, Malawi
| | | |
Collapse
|
5
|
Jauneikaite E, Baker KS, Nunn JG, Midega JT, Hsu LY, Singh SR, Halpin AL, Hopkins KL, Price JR, Srikantiah P, Egyir B, Okeke IN, Holt KE, Peacock SJ, Feasey NA. Genomics for antimicrobial resistance surveillance to support infection prevention and control in health-care facilities. Lancet Microbe 2023; 4:e1040-e1046. [PMID: 37977161 DOI: 10.1016/s2666-5247(23)00282-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 11/19/2023]
Abstract
Integration of genomic technologies into routine antimicrobial resistance (AMR) surveillance in health-care facilities has the potential to generate rapid, actionable information for patient management and inform infection prevention and control measures in near real time. However, substantial challenges limit the implementation of genomics for AMR surveillance in clinical settings. Through a workshop series and online consultation, international experts from across the AMR and pathogen genomics fields convened to review the evidence base underpinning the use of genomics for AMR surveillance in a range of settings. Here, we summarise the identified challenges and potential benefits of genomic AMR surveillance in health-care settings, and outline the recommendations of the working group to realise this potential. These recommendations include the definition of viable and cost-effective use cases for genomic AMR surveillance, strengthening training competencies (particularly in bioinformatics), and building capacity at local, national, and regional levels using hub and spoke models.
Collapse
Affiliation(s)
- Elita Jauneikaite
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, UK
| | - Kate S Baker
- Department of Clinical Infection, Microbiology, and Immunology, University of Liverpool, Liverpool, UK; Department of Genetics, University of Cambridge, Cambridge, UK.
| | - Jamie G Nunn
- Infectious Disease Challenge Area, Wellcome Trust, London, UK
| | | | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shweta R Singh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Alison L Halpin
- Division of Healthcare Quality Promotion, US Centers for Disease Control And Prevention, Atlanta, GA, USA
| | - Katie L Hopkins
- HCAI, Fungal, AMR, AMU, and Sepsis Division and Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, UK Health Security Agency, London, UK
| | - James R Price
- Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Padmini Srikantiah
- Global Health Division, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon-Accra, Ghana
| | - Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Kathryn E Holt
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK; Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | | | - Nicholas A Feasey
- Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK; Malawi Liverpool Wellcome Research Programme, Chichiri, Blantyre, Malawi
| |
Collapse
|
6
|
Baker KS, Jauneikaite E, Nunn JG, Midega JT, Atun R, Holt KE, Walia K, Howden BP, Tate H, Okeke IN, Carattoli A, Hsu LY, Hopkins KL, Muloi DM, Wheeler NE, Aanensen DM, Mason LCE, Rodgus J, Hendriksen RS, Essack SY, Egyir B, Halpin AL, MacCannell DR, Campos J, Srikantiah P, Feasey NA, Peacock SJ. Evidence review and recommendations for the implementation of genomics for antimicrobial resistance surveillance: reports from an international expert group. Lancet Microbe 2023; 4:e1035-e1039. [PMID: 37977164 DOI: 10.1016/s2666-5247(23)00281-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 11/19/2023]
Abstract
Nearly a century after the beginning of the antibiotic era, which has been associated with unparalleled improvements in human health and reductions in mortality associated with infection, the dwindling pipeline for new antibiotic classes coupled with the inevitable spread of antimicrobial resistance (AMR) poses a major global challenge. Historically, surveillance of bacteria with AMR typically relied on phenotypic analysis of isolates taken from infected individuals, which provides only a low-resolution view of the epidemiology behind an individual infection or wider outbreak. Recent years have seen increasing adoption of powerful new genomic technologies with the potential to revolutionise AMR surveillance by providing a high-resolution picture of the AMR profile of the bacteria causing infections and providing real-time actionable information for treating and preventing infection. However, many barriers remain to be overcome before genomic technologies can be adopted as a standard part of routine AMR surveillance around the world. Accordingly, the Surveillance and Epidemiology of Drug-resistant Infections Consortium convened an expert working group to assess the benefits and challenges of using genomics for AMR surveillance. In this Series, we detail these discussions and provide recommendations from the working group that can help to realise the massive potential benefits for genomics in surveillance of AMR.
Collapse
Affiliation(s)
- Kate S Baker
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK; Department of Genetics, University of Cambridge, Cambridge, UK.
| | - Elita Jauneikaite
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, UK
| | - Jamie G Nunn
- Infectious Disease Challenge Area, Wellcome Trust, London, UK
| | | | - Rifat Atun
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kathryn E Holt
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK; Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Kamini Walia
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, Ansarinagar, New Delhi, India
| | - Benjamin P Howden
- The Centre for Pathogen Genomics, Doherty Institute, The University of Melbourne, Melbourne, VIC, Australia
| | - Heather Tate
- Office of Research, US Food and Drug Administration Center for Veterinary Medicine, Laurel, MD, USA
| | - Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Li Yang Hsu
- Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Katie L Hopkins
- HCAI, Fungal, AMR, AMU, and Sepsis Division and Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, UK Health Security Agency, London, UK
| | - Dishon M Muloi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Animal and Human Health Department, International Livestock Research Institute, Nairobi, Kenya
| | - Nicole E Wheeler
- Institute of Microbiology and Infection, University of Birmingham, Birmingham, Edgbaston, UK
| | - David M Aanensen
- Centre for Genomic Pathogen Surveillance, Nuffield Department of Medicine, University of Oxford, Big Data Institute, Oxford, UK
| | - Lewis C E Mason
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Department of Clinical Infection, Microbiology, and Immunology, University of Liverpool, Liverpool, UK
| | - Jonah Rodgus
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance Department of Infectious Disease, Imperial College London, Hammersmith Hospital, London, UK
| | - Rene S Hendriksen
- National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Sabiha Y Essack
- Antimicrobial Research Unit, University of KwaZulu-Natal, Durban, South Africa
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon-Accra, Ghana
| | - Alison L Halpin
- Division of Healthcare Quality Promotion, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Duncan R MacCannell
- Office of Advanced Molecular Detection, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Josefina Campos
- National Center of Genomics and Bioinformatics, ANLIS Malbran, Buenos Aires, Argentina
| | - Padmini Srikantiah
- Global Health Division, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Nicholas A Feasey
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Malawi Liverpool Wellcome Research Programme, Blantyre, Malawi
| | | |
Collapse
|
7
|
Sartelli M, Barie PS, Coccolini F, Abbas M, Abbo LM, Abdukhalilova GK, Abraham Y, Abubakar S, Abu-Zidan FM, Adebisi YA, Adamou H, Afandiyeva G, Agastra E, Alfouzan WA, Al-Hasan MN, Ali S, Ali SM, Allaw F, Allwell-Brown G, Amir A, Amponsah OKO, Al Omari A, Ansaloni L, Ansari S, Arauz AB, Augustin G, Awazi B, Azfar M, Bah MSB, Bala M, Banagala ASK, Baral S, Bassetti M, Bavestrello L, Beilman G, Bekele K, Benboubker M, Beović B, Bergamasco MD, Bertagnolio S, Biffl WL, Blot S, Boermeester MA, Bonomo RA, Brink A, Brusaferro S, Butemba J, Caínzos MA, Camacho-Ortiz A, Canton R, Cascio A, Cassini A, Cástro-Sanchez E, Catarci M, Catena R, Chamani-Tabriz L, Chandy SJ, Charani E, Cheadle WG, Chebet D, Chikowe I, Chiara F, Cheng VCC, Chioti A, Cocuz ME, Coimbra R, Cortese F, Cui Y, Czepiel J, Dasic M, de Francisco Serpa N, de Jonge SW, Delibegovic S, Dellinger EP, Demetrashvili Z, De Palma A, De Silva D, De Simone B, De Waele J, Dhingra S, Diaz JJ, Dima C, Dirani N, Dodoo CC, Dorj G, Duane TM, Eckmann C, Egyir B, Elmangory MM, Enani MA, Ergonul O, Escalera-Antezana JP, Escandon K, Ettu AWOO, Fadare JO, Fantoni M, Farahbakhsh M, Faro MP, Ferreres A, Flocco G, Foianini E, Fry DE, Garcia AF, Gerardi C, Ghannam W, Giamarellou H, Glushkova N, Gkiokas G, Goff DA, Gomi H, Gottfredsson M, Griffiths EA, Guerra Gronerth RI, Guirao X, Gupta YK, Halle-Ekane G, Hansen S, Haque M, Hardcastle TC, Hayman DTS, Hecker A, Hell M, Ho VP, Hodonou AM, Isik A, Islam S, Itani KMF, Jaidane N, Jammer I, Jenkins DR, Kamara IF, Kanj SS, Jumbam D, Keikha M, Khanna AK, Khanna S, Kapoor G, Kapoor G, Kariuki S, Khamis F, Khokha V, Kiggundu R, Kiguba R, Kim HB, Kim PK, Kirkpatrick AW, Kluger Y, Ko WC, Kok KYY, Kotecha V, Kouma I, Kovacevic B, Krasniqi J, Krutova M, Kryvoruchko I, Kullar R, Labi KA, Labricciosa FM, Lakoh S, Lakatos B, Lansang MAD, Laxminarayan R, Lee YR, Leone M, Leppaniemi A, Hara GL, Litvin A, Lohsiriwat V, Machain GM, Mahomoodally F, Maier RV, Majumder MAA, Malama S, Manasa J, Manchanda V, Manzano-Nunez R, Martínez-Martínez L, Martin-Loeches I, Marwah S, Maseda E, Mathewos M, Maves RC, McNamara D, Memish Z, Mertz D, Mishra SK, Montravers P, Moro ML, Mossialos E, Motta F, Mudenda S, Mugabi P, Mugisha MJM, Mylonakis E, Napolitano LM, Nathwani D, Nkamba L, Nsutebu EF, O’Connor DB, Ogunsola S, Jensen PØ, Ordoñez JM, Ordoñez CA, Ottolino P, Ouedraogo AS, Paiva JA, Palmieri M, Pan A, Pant N, Panyko A, Paolillo C, Patel J, Pea F, Petrone P, Petrosillo N, Pintar T, Plaudis H, Podda M, Ponce-de-Leon A, Powell SL, Puello-Guerrero A, Pulcini C, Rasa K, Regimbeau JM, Rello J, Retamozo-Palacios MR, Reynolds-Campbell G, Ribeiro J, Rickard J, Rocha-Pereira N, Rosenthal VD, Rossolini GM, Rwegerera GM, Rwigamba M, Sabbatucci M, Saladžinskas Ž, Salama RE, Sali T, Salile SS, Sall I, Kafil HS, Sakakushev BE, Sawyer RG, Scatizzi M, Seni J, Septimus EJ, Sganga G, Shabanzadeh DM, Shelat VG, Shibabaw A, Somville F, Souf S, Stefani S, Tacconelli E, Tan BK, Tattevin P, Rodriguez-Taveras C, Telles JP, Téllez-Almenares O, Tessier J, Thang NT, Timmermann C, Timsit JF, Tochie JN, Tolonen M, Trueba G, Tsioutis C, Tumietto F, Tuon FF, Ulrych J, Uranues S, van Dongen M, van Goor H, Velmahos GC, Vereczkei A, Viaggi B, Viale P, Vila J, Voss A, Vraneš J, Watkins RR, Wanjiru-Korir N, Waworuntu O, Wechsler-Fördös A, Yadgarova K, Yahaya M, Yahya AI, Xiao Y, Zakaria AD, Zakrison TL, Zamora Mesia V, Siquini W, Darzi A, Pagani L, Catena F. Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action. World J Emerg Surg 2023; 18:50. [PMID: 37845673 PMCID: PMC10580644 DOI: 10.1186/s13017-023-00518-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023] Open
Abstract
Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or "golden rules," for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice.
Collapse
|
8
|
Chama MA, Dziwornu GA, Popli E, Mas-Claret E, Egyir B, Ayine-Tora DM, Owusu KBA, Reid DG, Osei-Safo D, Duer M, Mulholland D, Bender A. Antimicrobial and in silico studies of the triterpenoids of Dichapetalum albidum. Heliyon 2023; 9:e18299. [PMID: 37539285 PMCID: PMC10395534 DOI: 10.1016/j.heliyon.2023.e18299] [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: 02/20/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Here we report a new polyhydroxylated triterpene, 2β,6β,21α-trihydroxyfriedelan-3-one (4) isolated from the root and stem bark of Dichapetalum albidum A. Chev (Dichapetalaceae), along with six known triterpenoids (1-3, 5, 6, 8), sitosterol-3β-O-D-glucopyranoside (9), a dipeptide (7), and a tyramine derivative of coumaric acid (10). Friedelan-3-one (2) showed an antimicrobial activity (IC50) of 11.40 μg/mL against Bacillus cereus, while friedelan-3α-ol (1) gave an IC50 of 13.07 μg/mL against Staphylococcus aureus with ampicillin reference standard of 19.52 μg/mL and 0.30 μg/mL respectively. 3β-Acetyl tormentic acid (5) showed an IC50 of 12.50 μg/mL against Trypanosoma brucei brucei and sitosterol-3β-O-d-glucopyranoside (9) showed an IC50 of 5.06 μg/mL against Leishmania donovani with respective reference standards of IC50 5.02 μg/mL for suramin and IC50 0.27 μg/mL for amphotericin B. Molecular docking of the isolated compounds on the enzyme glucose-6-phosphate dehydrogenase (G6PDH) suggested 3β-acetyl tormentic acid (5) and sitosterol-3β-O-D-glucopyranoside (9) as plausible inhibitors of the enzyme in accordance with the experimental biological results observed.
Collapse
Affiliation(s)
- Mary A. Chama
- Department of Chemistry, SPMS, CBAS, University of Ghana, Ghana
| | | | - Elizabeth Popli
- Yusuf Hamied Department of Chemistry, University of Cambridge, United Kingdom
| | | | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Ghana
| | | | - Kofi B-A. Owusu
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Ghana
| | - David G. Reid
- Yusuf Hamied Department of Chemistry, University of Cambridge, United Kingdom
| | | | - Melinda Duer
- Yusuf Hamied Department of Chemistry, University of Cambridge, United Kingdom
| | - Dulcie Mulholland
- Department of Chemistry, University of Surrey, Guildford, United Kingdom
| | - Andreas Bender
- Yusuf Hamied Department of Chemistry, University of Cambridge, United Kingdom
| |
Collapse
|
9
|
Agbodzi B, Duodu S, Dela H, Kumordjie S, Yeboah C, Behene E, Ocansey K, Yanney JN, Boateng-Sarfo G, Kwofie SK, Egyir B, Colston SM, Miranda HV, Watters C, Sanders T, Fox AT, Letizia AG, Wiley MR, Attram N. Whole genome analysis and antimicrobial resistance of Neisseria gonorrhoeae isolates from Ghana. Front Microbiol 2023; 14:1163450. [PMID: 37455743 PMCID: PMC10339232 DOI: 10.3389/fmicb.2023.1163450] [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: 02/10/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Gonorrhoea is a major public health concern. With the global emergence and spread of resistance to last-line antibiotic treatment options, gonorrhoea threatens to be untreatable in the future. Therefore, this study performed whole genome characterization of Neisseria gonorrhoeae collected in Ghana to identify lineages of circulating strains as well as their phenotypic and genotypic antimicrobial resistance (AMR) profiles. Methods Whole genome sequencing (WGS) was performed on 56 isolates using both the Oxford Nanopore MinION and Illumina MiSeq sequencing platforms. The Comprehensive Antimicrobial Resistance Database (CARD) and PUBMLST.org/neisseria databases were used to catalogue chromosomal and plasmid genes implicated in AMR. The core genome multi-locus sequence typing (cgMLST) approach was used for comparative genomics analysis. Results and Discussion In vitro resistance measured by the E-test method revealed 100%, 91.0% and 85.7% resistance to tetracycline, penicillin and ciprofloxacin, respectively. A total of 22 sequence types (STs) were identified by multilocus sequence typing (MLST), with ST-14422 (n = 10), ST-1927 (n = 8) and ST-11210 (n = 7) being the most prevalent. Six novel STs were also identified (ST-15634, 15636-15639 and 15641). All isolates harboured chromosomal AMR determinants that confer resistance to beta-lactam antimicrobials and tetracycline. A single cefixime-resistant strain, that belongs to N. gonorrhoeae multiantigen sequence type (NG-MAST) ST1407, a type associated with widespread cephalosporin resistance was identified. Neisseria gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR), identified 29 unique sequence types, with ST-464 (n = 8) and the novel ST-3366 (n = 8) being the most prevalent. Notably, 20 of the 29 STs were novel, indicative of the unique nature of molecular AMR determinants in the Ghanaian strains. Plasmids were highly prevalent: pTetM and pblaTEM were found in 96% and 92% of isolates, respectively. The TEM-135 allele, which is an amino acid change away from producing a stable extended-spectrum β-lactamase that could result in complete cephalosporin resistance, was identified in 28.5% of the isolates. Using WGS, we characterized N. gonorrhoeae strains from Ghana, giving a snapshot of the current state of gonococcal AMR in the country and highlighting the need for constant genomic surveillance.
Collapse
Affiliation(s)
- Bright Agbodzi
- Naval Medical Research Unit No. 3, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Helena Dela
- Naval Medical Research Unit No. 3, Accra, Ghana
| | | | | | - Eric Behene
- Naval Medical Research Unit No. 3, Accra, Ghana
| | | | | | | | - Samuel Kojo Kwofie
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
- Biomedical Engineering Department, School of Engineering Sciences, University of Ghana, Accra, Ghana
| | - Beverly Egyir
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Sophie M. Colston
- Center for Bio/Molecular Science and Engineering, Naval Research Laboratory, Washington, DC, United States
| | | | | | | | - Anne T. Fox
- Naval Medical Research Unit No. 3, Accra, Ghana
| | | | | | | |
Collapse
|
10
|
Owusu FA, Obeng-Nkrumah N, Gyinae E, Kodom S, Tagoe R, Tabi BKA, Dayie NTKD, Opintan JA, Egyir B. Occurrence of Carbapenemases, Extended-Spectrum Beta-Lactamases and AmpCs among Beta-Lactamase-Producing Gram-Negative Bacteria from Clinical Sources in Accra, Ghana. Antibiotics (Basel) 2023; 12:1016. [PMID: 37370334 DOI: 10.3390/antibiotics12061016] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Beta-lactamase (β-lactamase)-producing Gram-negative bacteria (GNB) are of public health concern due to their resistance to routine antimicrobials. We investigated the antimicrobial resistance and occurrence of carbapenemases, extended-spectrum β-lactamases (ESBLs) and AmpCs among GNB from clinical sources. GNB were identified using matrix-assisted laser desorption/ionization time of flight-mass spectrometry (MALDITOF-MS). Antimicrobial susceptibility testing was performed via Kirby-Bauer disk diffusion and a microscan autoSCAN system. β-lactamase genes were determined via multiplex polymerase chain reactions. Of the 181 archived GNB analyzed, Escherichia coli and Klebsiella pneumoniae constituted 46% (n = 83) and 17% (n = 30), respectively. Resistance to ampicillin (51%), third-generation cephalosporins (21%), and ertapenem (21%) was observed among the isolates, with 44% being multi-drug resistant (MDR). β-lactamase genes such as AmpCs ((blaFOX-M (64%) and blaDHA-M and blaEDC-M (27%)), ESBLs ((blaCTX-M (81%), other β-lactamase genes blaTEM (73%) and blaSHV (27%)) and carbapenemase ((blaOXA-48 (60%) and blaNDM and blaKPC (40%)) were also detected. One K. pneumoniae co-harbored AmpC (blaFOX-M and blaEBC-M) and carbapenemase (blaKPC and blaOXA-48) genes. blaOXA-48 gene was detected in one carbapenem-resistant Acinetobacter baumannii. Overall, isolates were resistant to a wide range of antimicrobials including last-line treatment options. This underpins the need for continuous surveillance for effective management of infections caused by these pathogens in our settings.
Collapse
Affiliation(s)
- Felicia A Owusu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra 00233, Ghana
| | - Esther Gyinae
- Department of Microbiology, Korle-Bu Teaching Hospital, Accra 00233, Ghana
| | | | - Rhodalyn Tagoe
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana
| | - Blessing Kofi Adu Tabi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana
| | - Japheth A Opintan
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana
| |
Collapse
|
11
|
Camara N, Moremi N, Mghamba J, Eliakimu E, Shumba E, Ondoa P, Egyir B. Surveillance of antimicrobial resistance in human health in Tanzania: 2016-2021. Afr J Lab Med 2023; 12:2053. [PMID: 37293314 PMCID: PMC10244825 DOI: 10.4102/ajlm.v12i1.2053] [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: 08/08/2022] [Accepted: 03/09/2023] [Indexed: 06/10/2023] Open
Abstract
Background Antimicrobial resistance (AMR) surveillance plays an important role in early detection of resistant strains of pathogens and informs treatments decisions at local, regional and national levels. In 2017, Tanzania developed a One Health AMR Surveillance Framework to guide establishment of AMR surveillance systems in the human and animal sectors. Aim We reviewed AMR surveillance studies in Tanzania to document progress towards establishing an AMR surveillance system and determine effective strengthening strategies. Methods We conducted a literature review on AMR studies conducted in Tanzania by searching Google Scholar, PubMed, and the websites of the Tanzania Ministry of Health and the World Health Organization for articles written in English and published from January 2012 to March 2021 using relevant search terms. Additionally, we reviewed applicable guidelines, plans, and reports from the Tanzanian Ministry of Health. Results We reviewed 10 articles on AMR in Tanzania, where studies were conducted at hospitals in seven of Tanzania's 26 regions between 2012 and 2019. Nine AMR sentinel sites had been established, and there was suitable and clear coordination under 'One Health'. However, sharing of surveillance data between sectors had yet to be strengthened. Most studies documented high resistance rates of Gram-negative bacteria to third-generation cephalosporins. There were few laboratory staff who were well trained on AMR. Conclusion Important progress has been made in establishing a useful, reliable AMR surveillance system. Challenges include a need to develop, implement and build investment case studies for the sustainability of AMR surveillance in Tanzania and ensure proper use of third-generation cephalosporins. What this study adds This article adds to the knowledge base of AMR trends in Tanzania and progress made in the implementation of AMR surveillance in human health sector as a contribution to the global AMR initiatives to reduce AMR burden worldwide. It has highlighted key gaps that need policy and implementation level attention.
Collapse
Affiliation(s)
- Neema Camara
- Epidemiology and Disease Control Section, Ministry of Health, Dodoma, United Republic of Tanzania
| | - Nyambura Moremi
- Department of Bacteriology, National Public Health Laboratory, Dar es Salaam, United Republic of Tanzania
| | - Janneth Mghamba
- Epidemiology and Disease Control Section, Ministry of Health, Dodoma, United Republic of Tanzania
| | - Eliudi Eliakimu
- Health Quality Assurance Unit, Ministry of Health, Dodoma, United Republic of Tanzania
| | - Edwin Shumba
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Pascale Ondoa
- African Society for Laboratory Medicine, Addis Ababa, Ethiopia
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| |
Collapse
|
12
|
Dela H, Egyir B, Behene E, Sulemana H, Tagoe R, Bentil R, Bongo RNA, Bonfoh B, Zinsstag J, Bimi L, Addo KK. Microbiological quality and antimicrobial resistance of Bacteria species recovered from ready-to-eat food, water samples, and palm swabs of food vendors in Accra, Ghana. Int J Food Microbiol 2023; 396:110195. [PMID: 37030061 DOI: 10.1016/j.ijfoodmicro.2023.110195] [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: 10/10/2022] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 04/10/2023]
Abstract
This study sought to investigate microbial quality and antimicrobial resistance of bacteria species from Ready-to-Eat (RTE) food, water, and vendor palm swab samples. Between 2019 and 2020, RTE food, water and vendor palm swab samples were collected from food vending sites in Accra, Ghana. Samples were cultured and confirmed using the Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF). Antimicrobial susceptibility testing (AST) was conducted using disk diffusion method. Beta-lactamase and Diarrheagenic Escherichia coli (DEC) genes were determined using Polymerase Chain Reaction (PCR). Total plate count (TPC) and Total coliform count (TCC) were performed on food and water samples. In total, 179 RTE food, 72 water and 10 vendor palm swab samples were collected. Enterobacter spp. (16.8 %), Citrobacter spp. (10.1 %), Enterococcus faecalis (7.8 %), Pseudomonas spp. (6.7 %) and Klebsiella pneumoniae (4.0 %) occurred in food. Isolates from water and palm were Klebsiella pneumoniae (20.8 %), Aeromonas spp. (16.7 %) and Enterobacter cloacae (11.1 %). Resistance to Amoxicillin-clavulanate, Tetracycline, Azithromycin, Sulfamethoxazole-trimethoprim, and Nitrofurantoin were common among Enterobacterales. High mean TPC and TCC showed in some RTE food and different water types used in vending depicting their unsafe condition for consumption and usage. The blaSHV and blaTEM genes were present in some Enterobacterales from food and water. The lt gene was identified in two food samples. AMR organisms associated with nosocomial infections in the samples investigated, calls for continuous surveillance in the food industry in Ghana. Also, the unsafe outcome of RTE food and water depicts the need for the enforcement of Ghana's food safety laws.
Collapse
Affiliation(s)
- Helena Dela
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana; Department of Animal Biology and Conservation Science (DABCS), University of Ghana, Legon, Accra, Ghana.
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Eric Behene
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Hamdiya Sulemana
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Rodalyn Tagoe
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Ronald Bentil
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Richard N A Bongo
- Institut de Recherche en Elevage pour le Développement (IRED), N'djamena, Chad
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire (CSRS), Abidjan, Côte d'Ivoire
| | - Jakob Zinsstag
- Department of Epidemiology and Public Health (EPH), Swiss TPH, Basel, Switzerland
| | - Langbong Bimi
- Department of Animal Biology and Conservation Science (DABCS), University of Ghana, Legon, Accra, Ghana
| | - Kennedy Kwasi Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| |
Collapse
|
13
|
Adu B, Bonney JH, Egyir B, Otchere ID, Asare P, Dennis FE, Bonney EY, Akuffo R, Asante IA, Obodai E, Kumordjie S, Appiah-Kubi J, Mohktar Q, Frempong HO, Asiedu-Bekoe F, Adusei-Poku MA, Aboagye JO, Agbodzi B, Yeboah C, Agbenyo SB, Uche PO, Attiku KO, Sekyere BT, Laryea D, Buabeng K, Lamptey H, Ghansah A, Yeboah-Manu D, Anang AK, Ampofo WK, Kyei GB, Odoom JK. SARS-CoV-2 Molecular Evolutionary Dynamics in the Greater Accra Region, Ghana. Emerg Infect Dis 2023; 29:862-865. [PMID: 36958011 PMCID: PMC10045712 DOI: 10.3201/eid2904.221410] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
To assess dynamics of SARS-CoV-2 in Greater Accra Region, Ghana, we analyzed SARS-CoV-2 genomic sequences from persons in the community and returning from international travel. The Accra Metropolitan District was a major origin of virus spread to other districts and should be a primary focus for interventions against future infectious disease outbreaks.
Collapse
Affiliation(s)
| | | | - Beverly Egyir
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Francis E. Dennis
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Evelyn Yayra Bonney
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Richard Akuffo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Ivy A. Asante
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Evangeline Obodai
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Selassie Kumordjie
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Joyce Appiah-Kubi
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Quaneeta Mohktar
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Hilda Opoku Frempong
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Franklin Asiedu-Bekoe
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Mildred A. Adusei-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - James O. Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Bright Agbodzi
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Clara Yeboah
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Seyram B. Agbenyo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Peace O. Uche
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Keren O. Attiku
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Bernice Twenewaa Sekyere
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Dennis Laryea
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Kwame Buabeng
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Helena Lamptey
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Anita Ghansah
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Abraham K. Anang
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - William K. Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - George B. Kyei
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - John K. Odoom
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| |
Collapse
|
14
|
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.
Collapse
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: ,
| |
Collapse
|
15
|
Labi AK, Obeng-Nkrumah N, Dayie NTKD, Addo BM, Osei MM, Fenny A, Egyir B, Mensah JE. Occurrence and significance of fluoroquinolone-resistant and ESBL-producing Escherichia coli and Klebsiella pneumoniae complex of the rectal flora in Ghanaian patients undergoing prostate biopsy. JAC Antimicrob Resist 2022; 4:dlac113. [PMID: 36349243 PMCID: PMC9636584 DOI: 10.1093/jacamr/dlac113] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Background Reports suggest that fluoroquinolone (FQ)-resistant and ESBL-producing rectal flora are associated with infectious complications in men undergoing transrectal ultrasound-guided prostate needle biopsy (TRUS-B) Objectives We investigated the relationship between carriage of FQ-resistant and ESBL-producing Escherichia coli and Klebsiella pneumoniae complex of the rectal flora, and the 30 day incidence rate of post-TRUS-B infectious complications. Methods From 1 January 2018 to 30 April 2019, rectal swabs of 361 patients were cultured pre-TRUS-B for FQ-resistant and ESBL-producing flora. Patients were followed up for 30 days for infectious complications post-biopsy. Multivariable logistic regression analyses were used to identify risk factors. Results Overall, 86.4% (n = 312/361) and 62.6% (n = 226/361) of patients carried FQ-resistant and ESBL-producing E. coli and K. pneumoniae complex, respectively. Approximately 60% (n = 289/483) of the FQ-resistant and 66.0% (n = 202/306) of the ESBL-positive isolates exhibited in vitro resistance to the pre-biopsy prophylactic antibiotic regimen of levofloxacin and gentamicin. Amikacin and meropenem were the most effective antibiotics against the MDR rectal E. coli and K. pneumoniae complex (78.7% and 84.3%, respectively). The 30 day incidence rate for post-biopsy infections was 3.1% (n = 11/361), with an overall high probability (96.9%) of staying free of infections within the 30 day period post-TRUS-B. Antibiotic use in the previous 3 months was a risk factor for rectal carriage of FQ-resistant and ESBL-positive isolates. Rectal colonization by ESBL-positive E. coli and K. pneumoniae complex comprised an independent risk factor for post-biopsy infectious complications. Conclusions The findings suggest that a change in prophylactic antibiotics to a more targeted regimen may be warranted in our institution.
Collapse
Affiliation(s)
- Appiah-Korang Labi
- Department of Microbiology, Korle-Bu Teaching Hospital , PO Box 77, Accra , Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, University of Ghana School of Biomedical and Allied Health Sciences , PO Box KB 143, Accra , Ghana
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, University of Ghana Medical School , PO Box KB 143, Accra , Ghana
| | - Ben Molai Addo
- Department of Surgery, Urology Clinic, Korle-Bu Teaching Hospital , PO Box 77, Accra , Ghana
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, University of Ghana Medical School , PO Box KB 143, Accra , Ghana
| | - Ama Fenny
- Institute of Statistical, Social and Economic Research, University of Ghana , PO Box LG74, Accra , Ghana
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research , University of Ghana, P. O. Box LG 581, Accra , Ghana
| | - James Edward Mensah
- Department of Surgery University of Ghana Medical School , PO Box 4236, Accra , Ghana
| |
Collapse
|
16
|
Dela H, Egyir B, Majekodunmi AO, Behene E, Yeboah C, Ackah D, Bongo RNA, Bonfoh B, Zinsstag J, Bimi L, Addo KK. Diarrhoeagenic E. coli occurrence and antimicrobial resistance of Extended Spectrum Beta-Lactamases isolated from diarrhoea patients attending health facilities in Accra, Ghana. PLoS One 2022; 17:e0268991. [PMID: 35617316 PMCID: PMC9135277 DOI: 10.1371/journal.pone.0268991] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 06/10/2021] [Accepted: 05/12/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Diarrhoea accounts for high morbidity and mortality in children and adults worldwide. Extended Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL-PE) and Diarrhoeagenic Escherichia coli (DEC) contribute to prolonged hospitalization because of their resistance and virulence properties aiding in the spread of diarrhoeal disease and delayed treatment. AIM To determine DEC and the antimicrobial resistance of ESBL-PE isolated among diarrhoea patients attending two health facilities in Ghana. METHODS Stool samples were collected from 122 diarrhoeal patients who attended Maamobi General Hospital and Kaneshie Polyclinic between January 2019 and March 2020. Identification of bacteria was performed by using the Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Using disk diffusion, antimicrobial susceptibility testing (AST) was conducted and interpreted according to the 2018 CLSI guidelines. Detection of ESBL and DEC genes was performed using Polymerase chain reaction (PCR). RESULTS A total of 80.3% (98/122) Enterobacteriaceae was recovered from the patients in the study with an overall ESBL occurrence of 20.4% (20/98), predominantly among E. coli showed 13.2% (10/76), Klebsiella pneumoniae,35.7%(5/14) and Proteus mirabilis, 57.1%(4/7). Among the ESBL genes detected, blaTEM (n = 14) was common, followed by blaCTX-M (n = 13) and blaSHV (n = 4). Thirty-four E. coli isolates possessed the heat labile (Lt) gene of Enterotoxigenic E. coli (ETEC). CONCLUSION Our findings confirm the existence of DEC and the antimicrobial resistance patterns of ESBL-PE among stool isolates, limiting the options of commonly used drugs for diarrhoeal treatment in Ghana. Routine laboratory testing in health care facilities and strengthened surveillance systems among hospital networks are encouraged for a better understanding of their epidemiology and clinical implications.
Collapse
Affiliation(s)
- Helena Dela
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
- Department of Animal Biology and Conservation Science (DABCS), University of Ghana, Legon, Accra, Ghana
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Ayodele O. Majekodunmi
- Department of Animal Biology and Conservation Science (DABCS), University of Ghana, Legon, Accra, Ghana
| | - Eric Behene
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Clara Yeboah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Dominic Ackah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| | - Richard N. A. Bongo
- Institut de Recherche en Elevage pour le Développement (IRED), N’djamena, Chad
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire (CSRS), Abidjan, Côte d’Ivoire
| | - Jakob Zinsstag
- Department of Epidemiology and Public Health (EPH), Swiss TPH, Basel Switzerland
| | - Langbong Bimi
- Department of Animal Biology and Conservation Science (DABCS), University of Ghana, Legon, Accra, Ghana
| | - Kennedy Kwasi Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Accra, Ghana
| |
Collapse
|
17
|
Lawal OU, Ayobami O, Abouelfetouh A, Mourabit N, Kaba M, Egyir B, Abdulgader SM, Shittu AO. A 6-Year Update on the Diversity of Methicillin-Resistant Staphylococcus aureus Clones in Africa: A Systematic Review. Front Microbiol 2022; 13:860436. [PMID: 35591993 PMCID: PMC9113548 DOI: 10.3389/fmicb.2022.860436] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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] [Received: 01/22/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of hospital-associated (HA) and community-associated (CA) infections globally. The multi-drug resistant nature of this pathogen and its capacity to cause outbreaks in hospital and community settings highlight the need for effective interventions, including its surveillance for prevention and control. This study provides an update on the clonal distribution of MRSA in Africa. Methods A systematic review was conducted by screening for eligible English, French, and Arabic articles from November 2014 to December 2020, using six electronic databases (PubMed, EBSCOhost, Web of Science, Scopus, African Journals Online, and Google Scholar). Data were retrieved and analyzed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (registered at PROSPERO: CRD42021277238). Genotyping data was based primarily on multilocus sequence types (STs) and Staphylococcal Cassette Chromosome mec (SCCmec) types. We utilized the Phyloviz algorithm in the cluster analysis and categorization of the MRSA STs into various clonal complexes (CCs). Results We identified 65 studies and 26 publications from 16 of 54 (30%) African countries that provided sufficient genotyping data. MRSA with diverse staphylococcal protein A (spa) and SCCmec types in CC5 and CC8 were reported across the continent. The ST5-IV [2B] and ST8-IV [2B] were dominant clones in Angola and the Democratic Republic of Congo (DRC), respectively. Also, ST88-IV [2B] was widely distributed across the continent, particularly in three Portuguese-speaking countries (Angola, Cape Verde, and São Tomé and Príncipe). The ST80-IV [2B] was described in Algeria and Egypt, while the HA-ST239/ST241-III [3A] was only identified in Egypt, Ghana, Kenya, and South Africa. ST152-MRSA was documented in the DRC, Kenya, Nigeria, and South Africa. Panton-Valentine leukocidin (PVL)-positive MRSA was observed in several CCs across the continent. The median prevalence of PVL-positive MRSA was 33% (ranged from 0 to 77%; n = 15). Conclusion We observed an increase in the distribution of ST1, ST22, and ST152, but a decline of ST239/241 in Africa. Data on MRSA clones in Africa is still limited. There is a need to strengthen genomic surveillance capacity based on a "One-Health" strategy to prevent and control MRSA in Africa.
Collapse
Affiliation(s)
- Opeyemi Uwangbaoje Lawal
- Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa (ITQB-NOVA), Oeiras, Portugal
| | - Olaniyi Ayobami
- Unit for Healthcare-Associated Infections, Surveillance of Antimicrobial Resistance and Consumption, Robert Koch Institute, Berlin, Germany
| | - Alaa Abouelfetouh
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.,Department of Microbiology and Immunology, Faculty of Pharmacy, AlAlamein International University, Alalamein, Egypt
| | - Nadira Mourabit
- Biotechnology, Environmental Technology and Valorisation of Bio-Resources Team, Department of Biology, Faculty of Sciences and Techniques of Al Hoceima, Abdelmalek Essaadi University, Tetouan, Morocco
| | - Mamadou Kaba
- Division of Medical Microbiology, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Shima M Abdulgader
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Adebayo Osagie Shittu
- Department of Microbiology, Obafemi Awolowo University, Ile-Ife, Nigeria.,Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| |
Collapse
|
18
|
Aworh MK, Ekeng E, Nilsson P, Egyir B, Owusu-Nyantakyi C, Hendriksen RS. Extended-Spectrum ß-Lactamase-Producing Escherichia coli Among Humans, Beef Cattle, and Abattoir Environments in Nigeria. Front Cell Infect Microbiol 2022; 12:869314. [PMID: 35463650 PMCID: PMC9021871 DOI: 10.3389/fcimb.2022.869314] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Beef cattle, one of the food-producing animals, are linked to humans through a shared environment and the food chain as a major source of animal protein. Antimicrobial drugs are readily accessible for use in food animal production in Nigeria. Beef cattle and abattoir environments harbor pathogenic bacteria such as Escherichia coli (E. coli) which have developed resistance to antimicrobial agents used for prophylaxis or treatment. This study investigated the zoonotic transmission of extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) among humans, beef cattle, and abattoir environments in Abuja and Lagos, Nigeria. Materials and Methods We conducted a cross-sectional study among abattoir workers, beef cattle, and abattoir environments in Abuja and Lagos. Stool, cecal, and environmental samples were collected from apparently healthy workers, slaughtered cattle, and abattoir environments from May to December 2020. Data were collected electronically using open data kit app installed on a mobile phone. Antimicrobial susceptibility patterns were determined using the Kirby–Bauer disk diffusion method against a panel of 16 antimicrobial agents. Phenotypic and genotypic characterizations of the isolates were conducted. Data were analyzed with descriptive statistics. Results From 21.7% (n = 97) of 448 samples, ESBL-EC were isolated and further characterized. Prevalence of ESBL-EC was highest in cattle (45.4%; n = 44), abattoir workers (41.2%; n = 40), and abattoir environment (13.4%; n = 13). Whole-genome sequencing of ESBL-EC showed dissemination of blaCTX-M-15 (90.7%; n = 88); blaCTX-M-14 (5.2%; n = 5); and blaCTX-M-55 (2.1%; n = 2) genes. The blaCTX-M-15 coexisted with blaCTX-M-14 and blaTEM-1 genes in 2.1% (n = 2) and 39.2% (n = 38) of the isolates, respectively. The presence of blaCTX-M-14 and blaCTX-M-15 genes was significantly associated with isolates originating from abattoir workers when compared with beef cattle isolates (p = 0.05; p < 0.01). The most prevalent sequence types (ST) were ST10 (n = 11), ST215 (n = 7), ST4684 (n = 7), and ST2178 (n = 6). ESBL-EC strain (ST205/B1) harbored mcr-1.1 and blaCTX-M15 and was isolated from a worker at Lagos abattoir. In 91 ESBL-EC isolates, 219 mobile genetic elements (MGEs) harbored resistance genes out of which β-lactam genes were carried on 64 different MGEs. Isolates showed equal distribution of insertion sequences and miniature inverted repeats although only a few composite transposons were detected (humans n = 12; cattle n = 9; environment n = 4). Two isolates of human and cattle origin (ST46/A) harboring ESBL genes and carried by MGEs were clonally related. Conclusions This is the first report of blaCTX-M-55 gene in humans and cattle in Nigeria. This study demonstrates the horizontal transfer of ESBL genes possibly by MGEs and buttresses the importance of genomic surveillance. Healthcare workers should be sensitized that people working closely with cattle or in abattoir environments are a high-risk group for fecal carriage of ESBL-EC when compared with the general population.
Collapse
Affiliation(s)
- Mabel Kamweli Aworh
- Department of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- *Correspondence: Mabel Kamweli Aworh,
| | - Eme Ekeng
- National Reference Laboratory, Nigeria Center for Disease Control, Abuja, Nigeria
| | - Pernille Nilsson
- Technical University of Denmark, National Food Institute, WHO Collaborating Centre (WHO CC) for Antimicrobial Resistance in Foodborne Pathogens and Genomics, FAO Reference Laboratory (FAO RL) for Antimicrobial Resistance, Europea Union Reference Laboratory for Antimicrobial Resistance (EURL-AMR), Kongens Lyngby, Denmark
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Christian Owusu-Nyantakyi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Rene S. Hendriksen
- Technical University of Denmark, National Food Institute, WHO Collaborating Centre (WHO CC) for Antimicrobial Resistance in Foodborne Pathogens and Genomics, FAO Reference Laboratory (FAO RL) for Antimicrobial Resistance, Europea Union Reference Laboratory for Antimicrobial Resistance (EURL-AMR), Kongens Lyngby, Denmark
| |
Collapse
|
19
|
Labi AK, Obeng-Nkrumah N, Dayie NTKD, Egyir B, Sampane-Donkor E, Newman MJ, Opintan JA. Antimicrobial use in hospitalized patients: a multicentre point prevalence survey across seven hospitals in Ghana. JAC Antimicrob Resist 2021; 3:dlab087. [PMID: 34263166 PMCID: PMC8275021 DOI: 10.1093/jacamr/dlab087] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/25/2021] [Indexed: 01/19/2023] Open
Abstract
Background Antimicrobial resistance (AMR) is a public health crisis of global proportions. Data is required to understand the local drivers of antimicrobial resistance and support decision-making processes including implementation of appropriate antimicrobial stewardship strategies. Objectives To measure antimicrobial usage in hospitals in Ghana. Methods Using the Global Point Prevalence instruments and processes, we conducted point prevalence surveys across AMR surveillance sentinel hospitals in Ghana, between September and December 2019. Hospital records of all inpatients on admission at 0800 hours on a specific day were reviewed for antimicrobial use at the time of the survey. Data on antibiotic use, including indication for use and quality of prescribing were recorded. Results Overall prevalence of antibiotic use across the sentinel sites was 54.9% (n = 1591/2897), ranging between 48.4% (n = 266/550) and 67.2% (n = 82/122). The highest prevalence of antibiotic use 89.3% (n = 25/28) was observed in adult ICUs. The average number of antibiotics prescribed per patient was 1.7 (n = 1562/2620), with the majority (66%, n = 728/2620) administered via the parenteral route. The five most-commonly used antibiotics were metronidazole (20.6%, n = 541/2620), cefuroxime (12.9%, n = 338/2620), ceftriaxone (11.8%, n = 310/2620), amoxicillin/clavulanic acid (8.8%, n = 231/2620) and ciprofloxacin (7.8%, n = 204/2620). The majority (52.2%; n = 1367/2620) of antibiotics were prescribed to treat an infection, whilst surgical prophylaxis accounted for 26.1% (n = 684/2620). Conclusions We observed a high use of antibiotics including metronidazole and cephalosporins at the participating hospitals. Most antibiotics were empirically prescribed, with low use of microbiological cultures. High usage of third-generation cephalosporins especially for community-acquired infections offers an opportunity for antibiotic stewardship interventions.
Collapse
Affiliation(s)
- Appiah-Korang Labi
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Eric Sampane-Donkor
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Mercy Jemima Newman
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Japheth Awuletey Opintan
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
20
|
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.
Collapse
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.)
| |
Collapse
|
21
|
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.
Collapse
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.)
| |
Collapse
|
22
|
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.
Collapse
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.)
| |
Collapse
|
23
|
Egyir B, Nkrumah-Obeng N, Nyarko E, Fox A, Letizia A, Sanders T. 898. Prevalence of Extended Spectrum Beta-Lactamase Producing Escherichia coli, Klebsiella Pneumoniae and Pseudomonas Aeruginosa from Hospital Acquired Surgical Site Infections in Ghana. Open Forum Infect Dis 2020. [PMCID: PMC7776894 DOI: 10.1093/ofid/ofaa439.1086] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Globally, ESBL-producing bacteria pose a great challenge for treating hospital acquired SSI. Currently, the prevalence of ESBL pathogens in Ghana hospitals is poorly understood. Determining the frequency ESBLs are encountered will, in turn, provide insight for antibiogram development and shape antimicrobial stewardship policies in Ghana. Methods Using U.S. CDC criteria for SSI, wound swabs or aspirates were collected from 112 participants who met study inclusion criteria. Specimens were plated on MacConkey and blood agar; then colonies were isolated and identified using MALDI-TOF. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method and interpreted according to the 2018 Clinical and Laboratory Standards Institute (CLSI) guidelines. The combined disk method was used to screen for ESBLs among E.coli and K. pneumoniae isolates. Genes associated with ESBL production (SHV, TEM and CTX-M) were detected using PCR analysis. Results Thirty-eight percent of the bacterial isolates recovered were E. coli, K. pneumonia accounted for 32%, and P. aeruginosa accounted for 16% of the total isolates; remaining isolates were gram positive pathogens not discussed here. ESBL production was detected in 50% of E. coli isolates and 73% of K. pneumoniae isolates. ESBL-producing isolates were susceptible to meropenem but resistant to cefuroxime, cefotaxime, tetracycline, trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin and chloramphenicol. P. aeruginosa isolates were only sensitive to meropenem, gentamicin, and ciprofloxacin. In our study, CTX-M was the most frequently detected gene producing the ESBL-phenotype: 33% of E. coli isolates and 73% of K. pneumoniae isolates possessed the CTX-M gene. Conclusion Approximately 70% of total bacterial isolates recovered from our SSI study were ESBL producers. The presence of these multi-drug resistant organisms raises clinical concerns due to the absence of routine antimicrobial resistance (AMR) testing and lack of suitable first-line antimicrobials for ESBL pathogens. Improved laboratory capacity to more readily detect MDROs is essential for effective clinical management of patients, antibiogram development and refining antimicrobial stewardship practices in Ghana hospitals. Disclosures All Authors: No reported disclosures
Collapse
Affiliation(s)
- Beverly Egyir
- Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Greater Accra, Ghana
| | - Noah Nkrumah-Obeng
- Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Greater Accra, Ghana
| | - Edward Nyarko
- 37 Military Hospital Public Health Division, Accra, Greater Accra, Ghana
| | - Anne Fox
- Naval Medical Research Unit Three Ghana Detachment, Seattle, Washington
| | | | - Terrel Sanders
- Naval Medical Research Unit Three Ghana Detachment, Seattle, Washington
| |
Collapse
|
24
|
Adesoji TO, Egyir B, Shittu AO. Antibiotic-resistant staphylococci from the wastewater treatment plant and grey-water samples in Obafemi Awolowo University, Ile-Ife, Nigeria. J Water Health 2020; 18:890-898. [PMID: 33328361 DOI: 10.2166/wh.2020.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study examined the occurrence and molecular basis for antibiotic-resistant staphylococci from the wastewater treatment plant and grey-water samples in Obafemi Awolowo University, Nigeria. Standard microbiological techniques and molecular methods were utilized. The species identified (MALDI score >1.7) comprised S. saprophyticus (19), S. cohnii (8), S. sciuri (7), S. aureus (4), S. epidermidis (3), S. warneri (2), S. equorum (1), S. haemolyticus (1), S. nepalensis (1), S. condimenti (1), and S. pasteuri (1). Resistance to trimethoprim, tetracycline and cefoxitin were observed in 78.3% (47/60), 36.7% (22/60) and 25% (15/60) of the isolates, respectively. The rate of multidrug resistance was 53.3% (32/60) and observed in eight species from different sampling sites. Seven (S. sciuri; n = 5; S. aureus; n = 1; S. warneri; n = 1) of the 20 selected (representing the various staphylococcal species and antibiotypes) isolates were mecA-positive. Furthermore, the tetK gene was detected in nine isolates, six with dfrA, and four were positive for the dfrG gene. One S. aureus was mecA, tetK and dfrG gene positive. The study provides insights on antibiotic-resistant staphylococci from a non-clinical setting and highlights the need for active surveillance to understand the burden of antimicrobial resistance in Nigeria. This is key to improve synergy across the human, animal and environmental health sectors in Nigeria.
Collapse
Affiliation(s)
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Ghana
| | - Adebayo Osagie Shittu
- Department of Microbiology, Obafemi Awolowo University, Ile-Ife, Nigeria; †Current address: Institute of Medical Microbiology, University Hospital Münster, Domagkstrasse 10, 48149 Münster, Germany
| |
Collapse
|
25
|
Egyir B, Obeng-Nkrumah N, Kyei GB. COVID-19 pandemic and antimicrobial resistance: Another call to strengthen laboratory diagnostic capacity in Africa. Afr J Lab Med 2020; 9:1302. [PMID: 33102171 PMCID: PMC7567179 DOI: 10.4102/ajlm.v9i1.1302] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/07/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Beverly Egyir
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, University of Ghana, Accra, Ghana
| | - George B Kyei
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| |
Collapse
|
26
|
Dsani E, Afari EA, Danso-Appiah A, Kenu E, Kaburi BB, Egyir B. Antimicrobial resistance and molecular detection of extended spectrum β-lactamase producing Escherichia coli isolates from raw meat in Greater Accra region, Ghana. BMC Microbiol 2020; 20:253. [PMID: 32795260 PMCID: PMC7427773 DOI: 10.1186/s12866-020-01935-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 05/20/2020] [Accepted: 08/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Typically, raw meat can be contaminated with antibiotic resistant pathogens at unhygienic slaughter and sale points. Consumption of meat contaminated with antibiotic resistant E. coli is associated with grave health care consequences. The aim of this study was to determine the microbial quality of raw meat, the antimicrobial susceptibility and Extended Spectrum Beta Lactamase (ESBL) production in E. coli isolates from raw meat. RESULTS Total Plate Counts exceeded the acceptable limit of 5.0 log CFU/ cm2 in 60.5% (124/205) of raw meat samples. Total Coliform Counts in 70.7% (145/205) of samples were in excess of the acceptable limit of 2.5 log CFU/cm2. E. coli was detected in about half of raw meat samples (48%), ranging from 9.5-79.0% among the slaughter sites. Isolates were susceptible to meropenem (100%), ceftriaxone (99%), cefotaxime (98%), chloramphenicol (97%), gentamycin (97%), ciprofloxacin (92%) and amikacin (92%), but resistant to ampicillin (57%), tetracycline (45%), sulfamethoxazole-trimethoprim (21%) and cefuroxime (17%). Multi-drug resistance (MDR) was identified in 22% of the isolates. The blaTEM gene was detected in 4% (4/98) of E. coli isolates in this study. CONCLUSION The levels of microbial contamination of raw meat in this study were unacceptable. Meat handlers and consumers are at risk of foodborne infections from E. coli including ESBL producing E. coli that are resistant to most antibiotics in use. We recommend an enhanced surveillance for antibiotic resistance in food products for the early detection of emerging resistant bacteria species in the food chain.
Collapse
Affiliation(s)
- Esther Dsani
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.,Veterinary Services Directorate of the Ministry of Food and Agriculture, Accra, Ghana
| | - Edwin Andrews Afari
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Anthony Danso-Appiah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Ernest Kenu
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Basil Benduri Kaburi
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana
| | - Beverly Egyir
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
| |
Collapse
|
27
|
Ravens S, Fichtner AS, Willers M, Torkornoo D, Pirr S, Schöning J, Deseke M, Sandrock I, Bubke A, Wilharm A, Dodoo D, Egyir B, Flanagan KL, Steinbrück L, Dickinson P, Ghazal P, Adu B, Viemann D, Prinz I. Microbial exposure drives polyclonal expansion of innate γδ T cells immediately after birth. Proc Natl Acad Sci U S A 2020; 117:18649-18660. [PMID: 32690687 PMCID: PMC7414158 DOI: 10.1073/pnas.1922588117] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Starting at birth, the immune system of newborns and children encounters and is influenced by environmental challenges. It is still not completely understood how γδ T cells emerge and adapt during early life. Studying the composition of T cell receptors (TCRs) using next-generation sequencing (NGS) in neonates, infants, and children can provide valuable insights into the adaptation of T cell subsets. To investigate how neonatal γδ T cell repertoires are shaped by microbial exposure after birth, we monitored the γ-chain (TRG) and δ-chain (TRD) repertoires of peripheral blood T cells in newborns, infants, and young children from Europe and sub-Saharan Africa. We identified a set of TRG and TRD sequences that were shared by all children from Europe and Africa. These were primarily public clones, characterized by simple rearrangements of Vγ9 and Vδ2 chains with low junctional diversity and usage of non-TRDJ1 gene segments, reminiscent of early ontogenetic subsets of γδ T cells. Further profiling revealed that these innate, public Vγ9Vδ2+ T cells underwent an immediate TCR-driven polyclonal proliferation within the first 4 wk of life. In contrast, γδ T cells using Vδ1+ and Vδ3+TRD rearrangements did not significantly expand after birth. However, different environmental cues may lead to the observed increase of Vδ1+ and Vδ3+TRD sequences in the majority of African children. In summary, we show how dynamic γδ TCR repertoires develop directly after birth and present important differences among γδ T cell subsets.
Collapse
MESH Headings
- Africa South of the Sahara
- Bacteria/immunology
- Child
- Child, Preschool
- Europe
- Gene Rearrangement, T-Lymphocyte/genetics
- Gene Rearrangement, T-Lymphocyte/immunology
- Humans
- Infant
- Infant, Newborn
- Longitudinal Studies
- Receptors, Antigen, T-Cell, gamma-delta/genetics
- Receptors, Antigen, T-Cell, gamma-delta/immunology
- T-Lymphocyte Subsets/immunology
Collapse
Affiliation(s)
- Sarina Ravens
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany;
- Cluster of Excellence RESIST - Resolving Infection Susceptibility (EXC 2155), Hannover Medical School, 30625 Hannover, Germany
| | - Alina S Fichtner
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | - Maike Willers
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany
| | - Dennis Torkornoo
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | - Sabine Pirr
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany
| | - Jennifer Schöning
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany
| | - Malte Deseke
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | - Inga Sandrock
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | - Anja Bubke
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | - Anneke Wilharm
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
| | | | - Beverly Egyir
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Katie L Flanagan
- Vaccines and Immunity Theme, Medical Research Council Unit, Fajara, The Gambia
- School of Medicine, University of Tasmania, Launceston, TAS 7250, Australia
- School of Health & Biomedical Science, RMIT University, Melbourne, VIC 3083, Australia
- Department of Immunology and Pathology, Monash University, Melbourne, VIC 3004, Australia
| | - Lars Steinbrück
- Institute of Virology, Hannover Medical School, 30625 Hannover, Germany
| | - Paul Dickinson
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH16 4SB, United Kingdom
- Division of Infection and Pathway Medicine, University of Edinburgh, Edinburgh EH16 4SB, United Kingdom
| | - Peter Ghazal
- Division of Infection and Pathway Medicine, University of Edinburgh, Edinburgh EH16 4SB, United Kingdom
| | - Bright Adu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Dorothee Viemann
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, 30625 Hannover, Germany
- Cluster of Excellence RESIST - Resolving Infection Susceptibility (EXC 2155), Hannover Medical School, 30625 Hannover, Germany
- PRIMAL (priming immunity at the beginning of life) Consortium, Germany
| | - Immo Prinz
- Institute of Immunology, Hannover Medical School, 30625 Hannover, Germany
- Cluster of Excellence RESIST - Resolving Infection Susceptibility (EXC 2155), Hannover Medical School, 30625 Hannover, Germany
| |
Collapse
|
28
|
Baig S, Rhod Larsen A, Martins Simões P, Laurent F, Johannesen TB, Lilje B, Tristan A, Schaumburg F, Egyir B, Cirkovic I, Nimmo GR, Spiliopoulou I, Blanc DS, Mernelius S, Moen AEF, David MZ, Andersen PS, Stegger M. Evolution and Population Dynamics of Clonal Complex 152 Community-Associated Methicillin-Resistant Staphylococcus aureus. mSphere 2020; 5:e00226-20. [PMID: 32611695 PMCID: PMC7333568 DOI: 10.1128/msphere.00226-20] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 03/11/2020] [Accepted: 06/12/2020] [Indexed: 11/20/2022] Open
Abstract
Since the late 1990s, changes in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) were recognized with the emergence of community-associated MRSA (CA-MRSA). CA-MRSA belonging to clonal complex 152 (CC152), carrying the small staphylococcal cassette chromosome mec (SCCmec) type V and encoding the Panton-Valentine leukocidin (PVL), has been observed in Europe. The aim of this study was to investigate its origin, evolution, and dissemination. Whole-genome sequencing was performed on a global collection of 149 CC152 isolates spanning 20 years (93 methicillin-susceptible S. aureus [MSSA] and 56 MRSA isolates). Core genome phylogeny, Bayesian inference, in silico resistance analyses, and genomic characterization were applied. Phylogenetic analysis revealed two major distinct clades, one dominated by MSSA and the other populated only by MRSA. The MSSA isolates were predominately from sub-Saharan Africa, whereas MRSA was almost exclusively from Europe. The European MRSA isolates all harbored an SCCmec type V (5C2&5) element, whereas other SCCmec elements were sporadically detected in MRSA from the otherwise MSSA-dominated clade, including SCCmec types IV (2B), V (5C2), and XIII (9A). In total, 93% of the studied CC152 isolates were PVL positive. Bayesian coalescent inference suggests an emergence of the European CC152-MRSA in the 1990s, while the CC152 lineage dates back to the 1970s. The CA-MRSA CC152 clone mimics the European CC80 CA-MRSA lineage by its emergence from a PVL-positive MSSA ancestor from North Africa or Europe. The CC152 lineage has acquired SCCmec several times, but acquisition of SCCmec type V (5C2&5) seems associated with expansion of MRSA CC152 in Europe.IMPORTANCE Understanding the evolution of CA-MRSA is important in light of the increasing importance of this reservoir in the dissemination of MRSA. Here, we highlight the story of the CA-MRSA CC152 lineage using whole-genome sequencing on an international collection of CC152. We show that the evolution of this lineage is novel and that antibiotic usage may have the potential to select for the phage-encoded Panton-Valentine leukocidin. The diversity of the strains correlated highly to geography, with higher level of resistance observed among the European MRSA isolates. The mobility of the SCCmec element is mandatory for the emergence of novel MRSA lineages, and we show here distinct acquisitions, one of which is linked to the successful clone found throughout Europe today.
Collapse
Affiliation(s)
- Sharmin Baig
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Rhod Larsen
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Patrícia Martins Simões
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Laurent
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Thor Bech Johannesen
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Berit Lilje
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anne Tristan
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ivana Cirkovic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Graeme R Nimmo
- Pathology Queensland Central Laboratory, Griffith University School of Medicine, Queensland Health, Brisbane, Queensland, Australia
| | - Iris Spiliopoulou
- National Reference Laboratory for Staphylococci, Department of Microbiology, School of Medicine, University of Patras, Patras, Greece
| | - Dominique S Blanc
- Service of Hospital Preventive Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sara Mernelius
- Laboratory Medicine, Jönköping, Region Jönköping County, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Aina Elisabeth Fossum Moen
- Department of Clinical Molecular Biology (EpiGen), Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
- University of Oslo, Oslo, Norway
| | - Michael Z David
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paal Skytt Andersen
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marc Stegger
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| |
Collapse
|
29
|
Egyir B, Hadjirin NF, Gupta S, Owusu F, Agbodzi B, Adogla-Bessa T, Addo KK, Stegger M, Larsen AR, Holmes MA. Whole-genome sequence profiling of antibiotic-resistant Staphylococcus aureus isolates from livestock and farm attendants in Ghana. J Glob Antimicrob Resist 2020; 22:527-532. [PMID: 32439567 DOI: 10.1016/j.jgar.2020.03.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/02/2020] [Accepted: 03/25/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Epidemic methicillin-resistant Staphylococcus aureus (MRSA) clones have been described in Ghana, but so far, no typical livestock-associated MRSA isolates (CC398) have been found. In this study we provide baseline information on antimicrobial resistance, population structure, and virulence gene content of S. aureus isolates from livestock and farm attendants. METHODS Nasal samples were collected from cattle, pigs, goats, sheep, and farm attendants from three farms. Staphylococcus aureus was identified by matrix-assisted laser desorption/ionisation time-of-flight and antimicrobial susceptibility testing was performed using VITEK II (Biomerieux, Marcy l'Etoile, France) and interpreted according to EUCAST guidelines. Whole-genome sequencing was performed using the Illumina, San Diego, CA, USA MiSeq Platform. RESULTS In total, 401 nasal swab samples were obtained from 57 farm attendants, 208 pigs, 30 goats, 26 sheep, and 80 cattle. The S. aureus isolates (n = 25) recovered (farm attendants: n = 10; pigs: n = 8; and goats: n = 7) were frequently resistant to penicillin (68%), tetracycline (44%), and ciprofloxacin (32%); two human isolates were MRSA. Twelve isolates (48%) were multidrug resistant (MDR) (>3 classes). Genome sequencing of the isolates revealed ST152-t355, ST9-t1430, and ST133-t8662 as dominant clones among farm attendants, pigs, and goats, respectively. The two MRSA isolates detected belonged to ST8-t334 and ST152-t355. The scn and sak genes associated with human-adaption were detected in 10 isolates; 9 from humans and 1 from a goat. Typing results provided evidence of a single potential transmission event (t861, PVL-, scn+). CONCLUSION No MRSA was detected among livestock, perhaps because of low intensive farming; however, the relatively high prevalence of MDR isolates may be a result of inappropriate antibiotic usage in Ghanaian livestock production.
Collapse
Affiliation(s)
- Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
| | - Nazreen F Hadjirin
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Srishti Gupta
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Felicia Owusu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Bright Agbodzi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Tsatsu Adogla-Bessa
- Livestock and Poultry Research Centre Institute of Agricultural and Consumer Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kennedy Kwasi Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Marc Stegger
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Rhod Larsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Mark A Holmes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| |
Collapse
|
30
|
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.
Collapse
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,
| |
Collapse
|
31
|
Egyir B, Oteng AA, Owusu E, Newman MJ, Addo KK, Rhod-Larsen A. Characterization of Staphylococcus aureus from Human Immunodeficiency Virus (HIV) patients in Accra, Ghana. J Infect Dev Ctries 2016; 10:453-6. [PMID: 27249519 DOI: 10.3855/jidc.7428] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/04/2015] [Accepted: 09/09/2015] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The aims of this study were to: a) determine the nasal carriage prevalence of Stahpylococcus aureus among HIV patients, b) to characterize S. aureus strains isolated. METHODOLOGY Characterization of S. aureus isolates was done by antibiotyping, spa typing, and detection of Panton-Valentine leukocidin (PVL) genes. RESULTS S. aureus isolated (10/124; 8%) belonged to spa types t084 (n = 3), t10828 (n = 2), t311, t304, t774, t645, and t091. The isolates were resistant to penicillin (100%), tetracycline (40%), rifampicin (10%), fucidic acid (10%), norfloxacin (10%), erythromycin (10%), and sulfamethoxazole trimethoprim (10%). Multidrug resistance (MDR) was detected in 30% of the isolates. CONCLUSION The finding of MDR S. aureus among HIV-positive patients suggests that surveillance of antimicrobial resistant S. aureus among this patient group could be considered as an infection control measure in the hospital.
Collapse
|
32
|
Egyir B, Guardabassi L, Esson J, Nielsen SS, Newman MJ, Addo KK, Larsen AR. Insights into nasal carriage of Staphylococcus aureus in an urban and a rural community in Ghana. PLoS One 2014; 9:e96119. [PMID: 24760001 PMCID: PMC3997564 DOI: 10.1371/journal.pone.0096119] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [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: 01/02/2014] [Accepted: 04/03/2014] [Indexed: 11/19/2022] Open
Abstract
The epidemiology of Staphylococcus aureus in the community in Ghana was never investigated prior to this study. The aims of the study were: i) to assess prevalence of nasal S. aureus carriage in Ghanaian people living in an urban and a rural area, and ii) to identify phenotypic and genotypic traits of strains isolated from the two communities. Nasal swabs were collected from healthy individuals living in an urban community situated in the suburb of the capital city, Accra (n = 353) and in a rural community situated in the Dangme-West district (n = 234). The overall prevalence of nasal carriage was 21% with a significantly higher prevalence in the urban (28%) than in the rural community (11%) (p<0.0001). The levels of antimicrobial resistance were generally low (<5%) except for penicillin (91%) and tetracycline (25%). The only two (0.3%) MRSA carriers were individuals living in the urban area and had been exposed to hospitals within the last 12 months prior to sampling. Resistance to tetracycline (p = 0.0009) and presence of Panton-Valentine leukocidin (PVL) gene (p = 0.02) were significantly higher among isolates from the rural community compared to isolates from the urban community. Eleven MLST clonal complexes (CC) were detected based on spa typing of the 124 S. aureus isolates from the two communities: CC8 (n = 36), CC152 (n = 21), CC45 (n = 21), CC15 (n = 18), CC121 (n = 6), CC97 (n = 6), CC30 (n = 5), CC5 (n = 5), CC508 (n = 4), CC9 (n = 1), and CC707 (n = 1). CC8 and CC45 were less frequent in the rural area than in the urban area (p = 0.02). These results reveal remarkable differences regarding carriage prevalence, tetracycline resistance, PVL content and clonal distribution of S. aureus in the two study populations. Future research may be required to establish whether such differences in nasal S. aureus carriage are linked to socio-economic differences between urban and rural communities in this African country.
Collapse
Affiliation(s)
- Beverly Egyir
- Department of Microbiology and Infection Control, Statens Serum Insitut, Copenhagen, Denmark
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
- * E-mail:
| | - Luca Guardabassi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Joseph Esson
- Microbiology Department, University of Ghana Medical School, Accra, Ghana
| | - Søren Saxmose Nielsen
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Kennedy Kwasi Addo
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Anders Rhod Larsen
- Department of Microbiology and Infection Control, Statens Serum Insitut, Copenhagen, Denmark
| |
Collapse
|
33
|
Egyir B, Guardabassi L, Sørum M, Nielsen SS, Kolekang A, Frimpong E, Addo KK, Newman MJ, Larsen AR. Molecular epidemiology and antimicrobial susceptibility of clinical Staphylococcus aureus from healthcare institutions in Ghana. PLoS One 2014; 9:e89716. [PMID: 24586981 PMCID: PMC3934920 DOI: 10.1371/journal.pone.0089716] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [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: 10/08/2013] [Accepted: 01/23/2014] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to determine the antimicrobial susceptibility patterns and clonal diversity of clinical Staphylococcus aureus isolates from Ghana. A total of 308 S. aureus isolates from six healthcare institutions located across Northern, Central and Southern Ghana were characterized by antibiotyping, spa typing and PCR detection of Panton Valentine leukocin (PVL) genes. Methicillin-resistant S. aureus (MRSA) were confirmed by PCR detection of mecA gene and further characterized by SCCmec and multi-locus sequence typing (MLST). The prevalence of antimicrobial resistance was below 5% for all agents tested except for penicillin (97%), tetracycline (42%) and erythromycin (6%). Ninety-one spa types were found, with t355 (ST152, 19%), t084 (ST15, 12%) and t314 (ST121, 6%) being the most frequent types. Based on established associations between spa and MLST types, isolates were assigned to 16 clonal complexes (CCs): CC152 (n = 78), CC15 (n = 57), CC121 (n = 39), CC8 (n = 36), CC5 (n = 33), CC1 (n = 29), CC45 (n = 9), CC88 (n = 8), CC30 (n = 4), CC9 (n = 3), CC25 (n = 2), CC97 (n = 2) CC20 (n = 2), CC707 (n = 2), CC7 (n = 3) and CC522 (n = 1). Most isolates (60%) were PVL-positive, especially those belonging to ST152, ST121, ST5, ST15, ST1, ST8, and ST88. Nine (3%) isolates were MRSA belonging to seven distinct clones: ST88-IV (n = 2), ST250-I (n = 2), ST8-IV (n = 1), ST72-V (n = 1), ST789-IV (n = 1), ST2021-V (n = 1), and ST239-III (n = 1). The study confirmed a high frequency of PVL-positive S. aureus in Africa, low prevalence of antimicrobial resistance and high diversity of MRSA lineages in Ghana compared to developed countries and other African countries. The detection of known pandemic MRSA clones in the absence of routine MRSA identification in most Ghanaian clinical microbiology laboratories calls for capacity building to strengthen surveillance and prevent spread of these clones.
Collapse
Affiliation(s)
- Beverly Egyir
- Department of Microbiology and Infection Control, Statens Serum Insitut, Copenhagen, Denmark
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
- * E-mail:
| | - Luca Guardabassi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Marit Sørum
- Department of Microbiology and Infection Control, Statens Serum Insitut, Copenhagen, Denmark
| | - Søren Saxmose Nielsen
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Augusta Kolekang
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Enoch Frimpong
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kennedy Kwasi Addo
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | | | - Anders Rhod Larsen
- Department of Microbiology and Infection Control, Statens Serum Insitut, Copenhagen, Denmark
| |
Collapse
|
34
|
Egyir B, Guardabassi L, Nielsen SS, Larsen J, Addo KK, Newman MJ, Larsen AR. Prevalence of nasal carriage and diversity of Staphylococcus aureus among inpatients and hospital staff at Korle Bu Teaching Hospital, Ghana. J Glob Antimicrob Resist 2013; 1:189-193. [PMID: 27873611 DOI: 10.1016/j.jgar.2013.05.006] [Citation(s) in RCA: 40] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 05/21/2013] [Accepted: 05/31/2013] [Indexed: 11/28/2022] Open
Abstract
There is a paucity of data on Staphylococcus aureus epidemiology in Africa. Prevalence of nasal carriage and genetic diversity of S. aureus were determined among hospital staff (HS) and inpatients (IP) at the largest hospital in Ghana. In total, 632 nasal swabs were obtained from 452 IP and 180 HS in the Child Health Department (CHD) and Surgical Department (SD). S. aureus carriage prevalences were 13.9% in IP and 23.3% in HS. The chance of being a carrier was higher in HS (P=0.005) and IP staying ≤7 days in hospital (P=0.007). Resistance to penicillin (93%), tetracycline (28%) and fusidic acid (12%) was more common than for other agents (<5%). A higher chance of multidrug-resistant S. aureus carriage was observed among IP compared with HS (P=0.01). High genetic diversity was shown by spa typing, with 55 spa types found among 105 isolates; the predominant spa types were t355 (10%) and t084 (10%). MRSA was detected in six IP with an overall carriage prevalence of ca. 1.3%, but not in HS. All three MRSA isolates from SD belonged to ST88-SCCmec IV, and two of them displayed the same spa type and antibiograms; three MRSA isolates from CHD belonged to distinct lineages (ST88-SCCmec IV, ST8-SCCmec V and ST72-SCCmec V). Altogether, these data indicate a high diversity of S. aureus, low levels of MRSA carriage, and a higher chance of nasal carriage of multidrug-resistant S. aureus among IP compared with HS in this hospital.
Collapse
Affiliation(s)
- Beverly Egyir
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark; Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana.
| | - Luca Guardabassi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Søren Saxmose Nielsen
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jesper Larsen
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Kennedy Kwasi Addo
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | | | - Anders Rhod Larsen
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| |
Collapse
|
35
|
Dodoo D, Atuguba F, Bosomprah S, Ansah NA, Ansah P, Lamptey H, Egyir B, Oduro AR, Gyan B, Hodgson A, Koram KA. Antibody levels to multiple malaria vaccine candidate antigens in relation to clinical malaria episodes in children in the Kasena-Nankana district of Northern Ghana. Malar J 2011; 10:108. [PMID: 21529376 PMCID: PMC3101166 DOI: 10.1186/1475-2875-10-108] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 05/01/2011] [Indexed: 11/20/2022] Open
Abstract
Background Considering the natural history of malaria of continued susceptibility to infection and episodes of illness that decline in frequency and severity over time, studies which attempt to relate immune response to protection must be longitudinal and have clearly specified definitions of immune status. Putative vaccines are expected to protect against infection, mild or severe disease or reduce transmission, but so far it has not been easy to clearly establish what constitutes protective immunity or how this develops naturally, especially among the affected target groups. The present study was done in under six year old children to identify malaria antigens which induce antibodies that correlate with protection from Plasmodium falciparum malaria. Methods In this longitudinal study, the multiplex assay was used to measure IgG antibody levels to 10 malaria antigens (GLURP R0, GLURP R2, MSP3 FVO, AMA1 FVO, AMA1 LR32, AMA1 3D7, MSP1 3D7, MSP1 FVO, LSA-1and EBA175RII) in 325 children aged 1 to 6 years in the Kassena Nankana district of northern Ghana. The antigen specific antibody levels were then related to the risk of clinical malaria over the ensuing year using a negative binomial regression model. Results IgG levels generally increased with age. The risk of clinical malaria decreased with increasing antibody levels. Except for FMPOII-LSA, (p = 0.05), higher IgG levels were associated with reduced risk of clinical malaria (defined as axillary temperature ≥37.5°C and parasitaemia of ≥5000 parasites/ul blood) in a univariate analysis, upon correcting for the confounding effect of age. However, in a combined multiple regression analysis, only IgG levels to MSP1-3D7 (Incidence rate ratio = 0.84, [95% C.I.= 0.73, 0.97, P = 0.02]) and AMA1 3D7 (IRR = 0.84 [95% C.I.= 0.74, 0.96, P = 0.01]) were associated with a reduced risk of clinical malaria over one year of morbidity surveillance. Conclusion The data from this study support the view that a multivalent vaccine involving different antigens is most likely to be more effective than a monovalent one. Functional assays, like the parasite growth inhibition assay will be necessary to confirm if these associations reflect functional roles of antibodies to MSP1-3D7 and AMA1-3D7 in this population.
Collapse
Affiliation(s)
- Daniel Dodoo
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Egyir B, Brown C, Wilson M, Koram K. Distribution and Genetic Diversity of Plasmodium falciparum Erythrocyte Binding Antigen 175 and Clinical Outcome of Malaria in the Kassena-Nankana District. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|