Carriage of Antibiotic Resistant Bacteria and Associated Factors Among Food Handlers in Tamale Metropolis, Ghana: Implications for Food Safety

Background

Bacteria pathogens constitute a significant proportion of diarrhoea-causing food contaminants. Transmission of antibiotic resistant foodborne pathogens to humans is a major threat to food safety, especially in developing countries where quality hygiene and sanitation facilities are lacking. Factors related to antibiotic use, sanitation and hand hygiene have been associated with the spread of infectious diseases as well as antibiotic resistant bacteria. Proper food handling ensures that food is not contaminated with potential pathogenic bacteria. This study assessed the carriage of antibiotic resistant bacteria and associated factors.

Methods

A cross-sectional study was conducted among food handlers who sell ready to eat food in the Tamale metropolis of the Northern Region of Ghana. Food vending stations with huge customer base were randomly selected and the food handlers recruited using written informed consent. Structured questionnaires were used to collect participants sociodemographic details and information on sanitation, hand hygiene practice and antibiotic use. Sterile cotton swabs soaked in phosphate buffered saline was used to swab the palms of participating food handlers for bacteria isolation. All identified bacteria were tested for susceptibility to 12 antibiotics.

Results

In all, 406 food handlers participated in this study, the mean (SD) age was 26.5 (2.64) years. Bacteria isolated were predominantly Staphylococci 60 (14.8%) and Escherichia coli 54 (13.3%). All the isolates were resistant to at least one antibiotic tested. The isolates showed high resistance to broad-spectrum antibiotics such as ampicillin (40.0%-75.0%), tetracycline (40.0%-80.0%), amoxiclav (20.0%-80.0%) and chloramphenicol (7.7%-50.0%). Logistic regression model revealed that the carriage of antibiotic resistant bacteria by food handlers was significantly associated with age, educational level, years on the job, training in food preparation, hygiene practice, water source, type of toilet facility used and antibiotic use.

Conclusion

Street food handlers could be potential sources of food-borne transmission of antibiotic resistant bacteria.

Pregnancy and the risk of NICU admissions in Nandom Municipality of Ghana: A cross-sectional retrospective study

Background

Neonatal intensive care units (NICU) are specialized units that provide medical attention to neonates, and thus have become a vital aspect in the provision of critical care to infants who are faced with special challenges following birth.

Aim

To determine antepartum and intrapartum factors that predispose to NICU admissions in the Nandom Municipal of the Upper West Region of Ghana.

Method

This was a cross-sectional retrospective study, spanning from January 1, 2021 to December 31, 2021. Records covering 1777 women who were delivered or had their babies referred to the St. Theresa's Hospital in the Nandom Municipality were involved in the study. Descriptive statistics and multinomial logistic regression analysis were used to compare variables, and statistical significance was determined where the p-value was less than 0.05.

Results

From the study, the rate of NICU admission was 10.4%. There was a significant association between mothers who attended less than four antenatal sessions (p = 0.004) and admission to NICU. Nulliparous mothers (p = 0.027) and mothers who presented with multiple pregnancy (p < 0.001) were more likely to have their babies sent to NICU. Both preterm delivery (p < 0.001) and post-term delivery (p < 0.001) were prone to admission to NICU. Also, instrumental delivery (p < 0.001), cesarean section (p < 0.001), low birth weight (p < 0.001), and male infants (p = 0.003) had an increased risk of being admitted to NICU. Furthermore, severe (p < 0.001) and moderate (p < 0.001) birth asphyxia in the first minute following delivery were significantly associated with NICU admission whereas severely asphyxiated babies at 5 min (p < 0.001) were associated with NICU admission.

Conclusion

The study revealed a relatively high NICU admission rate in the study area, and the predictors are multifaceted. Tailored intervention programs aimed at curbing these predictors will be required to reduce the rate of NICU admissions in the Nandom Municipality of Ghana.

Safety of Retailed Poultry: Analysis of Antibiotic Resistance in Escherichia coli From Raw Chicken and Poultry Fecal Matter From Selected Farms and Retail Outlets in Accra, Ghana

Purpose:

To assess the safety of retailed poultry using the prevalence of antibiotic resistance in Escherichia coli ( E. coli), a dominant intestinal microflora.

Methods:

Two medium-scale farms and 8 well-known retail outlets within the La-Nkwantanang Madina municipality in Accra were purposively selected for sampling from January to March 2020. We randomly sampled raw chicken (n = 25) and poultry fecal matter (n = 50). All samples were immediately transported on ice to the laboratory for analysis within 12 hours after collection. Conventional culture techniques, biochemical tests, and matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF-MS) were used for isolation and identification. The antimicrobial susceptibility of isolated E. coli strains (n = 36) was tested using the Kirby Bauer disk diffusion method.

Results:

Antimicrobial resistance in E. coli ranged from 10.7 % (cefotaxime) to 82.1% (tetracycline) in fecal matter and 0% (gentamicin & cefotaxime) to 62.5% (tetracycline) in chicken. The prevalence of antimicrobial resistant E. coli in fecal samples was higher than in chicken for almost all antibiotics tested, except for cefoxitin, cefuroxime, and ceftazidime. Multidrug resistance was 57.1% in E. coli from fecal samples compared to 62.5% in chicken.

Conclusion:

The high level of resistance to E. coli in fecal matter is of public health concern because cross-contamination often occurs during slaughter and processing. This calls for close surveillance and strict adherence to Hazard Analysis and Critical Control Point (HACCP) principles in the chicken production chain to prevent the transmission of antimicrobial-resistant E. coli strains through the food chain.