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Antimicrob Resist Infect Control. 2018 Mar 9;7:37. doi: 10.1186/s13756-018-0324-2. eCollection 2018.

Multidrug-resistant gram-negative bacterial infections in a teaching hospital in Ghana.

Author information

1
1Antimicrobial Research Unit, Discipline of Pharmaceutical Sciences, University of Kwa-Zulu Natal, Durban, South Africa.
2
2School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract

Background:

Multidrug-resistant Gram-negative bacteria have emerged as major clinical and therapeutic dilemma in hospitals in Ghana.To describe the prevalence and profile of infections attributable to multidrug-resistant Gram-negative bacteria among patients at the Komfo Anokye Teaching Hospital in the Ashanti region of Ghana.

Methods:

Bacterial cultures were randomly selected from the microbiology laboratory from February to August, 2015. Bacterial identification and minimum inhibitory concentrations were conducted using standard microbiological techniques and the Vitek-2 automated system. Patient information was retrieved from the hospital data.

Results:

Of the 200 isolates, consisting of K. pneumoniae, A. baumannii, P. aeruginosa, Enterobacter spp., E. coli, Yersinia spp., Proteus mirabilis, Pasteurella spp., Chromobacterium violaceum, Salmomella enterica, Vibrio spp., Citrobacter koseri, Pantoea spp., Serratia spp., Providencia rettgeri Burkholderia cepacia, Aeromonas spp., Cadecea lapagei and Sphingomonas paucimobilis, 101 (50.5%) and 99 (49.5%) recovered from male and female patients respectively The largest proportion of patients were from age-group ≥60 years (24.5%) followed by < 10 years (24.0%) and least 10-19 years (9.5%) with a mean patient age of 35.95 ± 27.11 (0.2-91) years. The decreasing order of specimen source was urine 97 (48.5%), wound swabs 47 (23.5%), sputum 22 (11.0%) bronchial lavage, nasal and pleural swabs 1 (0.50%). Urinary tract infection was diagnosed in 34.5% of patients, sepsis in 14.5%, wound infections (surgical and chronic wounds) in 11.0%, pulmonary tuberculosis in 9.0% and appendicitis, bacteremia and cystitis in 0.50%. The isolates showed high resistance to ampicillin (94.4%), trimethoprim/sulfamethoxazole (84.5%), cefuroxime (79.0%) and cefotaxime (71.3%) but low resistance to ertapenem (1.5%), meropenem (3%) and amikacin (11%). The average multi-drug resistance was 89.5%, and ranged from 53.8% in Enterobacter spp. to 100.0% in Acinetobacter spp. and P. aeruginosa.

Conclusion:

Bacterial infections caused by multi-drug resistant (isolates resistant to at least one agent in three or more antibiotic classes) Gram-negative pathogens among patients at Komfo Anokye Teaching Hospital in Kumasi, Ghana are rife and interventions are necessary for their containment.

KEYWORDS:

Antibiotic resistance; Infections; Multidrug resistance; Pathogens

Conflict of interest statement

Ethical clearance was approved by the joint Committee of Human Research Publications and Ethics, School of Medical Sciences, Kwame Nkrumah University of Technology, Research and Development Unit of the Hospital Administration (ref: CHRPE/AP/015/15) and the Biomedical Research Ethics Committee of University of Kwa-Zulu Natal (ref: BE 494/14). Informed consent was obtained from all participants, and from parents or guardians for minors in written form either signed or by a thumb print after explanation of the procedure and the purpose of the study.Not applicableProfessor Essack is a member of the Global Respiratory Infection Partnership sponsored by an unrestricted educational grant from Reckitt and Benckiser, UK. The other authors have no competing interest to declare.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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