Study of Escherichia coli as a Cause of Diarrhoea in the Ashanti Region of Ghana

Even though diarrhoeagenic Escherichia coli (E. coli) is accepted worldwide as essential diarrhoea-causing agent, especially among children, routinely they are not sought as a stool sample pathogen in many microbiological laboratories. The conventional biochemical means are not able to differentiate E. coli which is a normal flora in the gastrointestinal tract from the pathogenic strains. This research work sought to detect and identify diarrhoeagenic E. coli in the Ashanti region of Ghana by using conventional multiplex PCR. A convenient sampling method was employed to select a total of 502 patients from Ashanti Regional and St. Michael’s Hospitals for the study. In all, five pathotypes of diarrhoeagenic E. coli were detected with enterotoxigenic E. coli (ETEC) as the most frequent. The target genes considered for each group of diarrhoeagenic E. coli were eaeA (E. coli attaching- effacing) and bfpA (bundle forming pilus A) for enteropathogenic E. coli (EPEC), elt and Stla for enterotoxigenic E. coli (ETEC), ial for enteroinvasive E. coli (EIEC), CVD432 for enteroaggregative E. coli (EAEC), and hlyA for enterohaemorrhagic E. coli (EHEC). Generally, some of the participants (31.08% = n/N= 69/222) exhibited symptoms of diarrhoea while others did not (68.92% = n/N =153/222 ), although they were positive for the pathotypes. The virulence factors considered were seen as contributory factors to the symptomatic situations. Participants in the ≤5 and  ≥ 42-year groups were seen to be more vulnerable to diarrhoea. Additionally, it was discovered that men were more susceptible to diarrhoea than women. The study therefore recommends more studies into the ≥ 42-year group not neglecting that of children. In addition, this current study suggests the routine utilization of molecular methods such as conventional multiplex PCR to identify and detect the pathotypes of E. coli causing diarrhoea

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Assessment of sugarcane grown in wetlands polluted with wastewater

Wastewater effluents directly discharged into nearby stream are eventually used to irrigate plants like sugarcane in Ghana. In this study, 24 triplicates sugarcane stems (sugarcane juice was extracted), 24 triplicates soil samples and 8 triplicates water samples were collected from sugarcane farms in four communities in Ashanti region of Ghana. Two of the communities were exposed to wastewater while the other two without wastewater contamination served as control. Metals (Pb, Cd, Cr, Cu, and Fe) concentration were determined in the digested samples using Spectra AA 220 flame atomic absorption spectrometer. The Pb concentration in all sugarcane juice samples ranged between 12.65 and 145.0 μg/L. The mean Cu concentration of the sugarcane juice samples varied between 11.28 and 156.00 μg/L. In general, there were decrease in metals investigated in sugarcane juice as you move away from the stream. However, the reduction was more pronounced in the hotspot sampling areas than control sampling areas. The EDI value was 9.76 × 10−4, 2.94 × 10−5, 1.09 × 10−3, and 9.07 × 10−3 (mg/kg-day) for Pb, Cd, Cu, and Fe, respectively. Mean hazard quotient (HQ) for the metals studied ranged from 0.036 (Fe) to 0.286 (Pb). The results of this study indicate that sugarcane is able to grow in soils where some metals are accumulated. High levels of metals were pronounced in sugarcane originating from wastewater polluted soils as those considered in this study. The consumption of normal quantity of sugarcane juice may not present detrimental health concerns through a lifetime based on the metals contents alone

Assessment of sugarcane grown in wetlands polluted with wastewater

<p>Wastewater effluents directly discharged into nearby stream are eventually used to irrigate plants like sugarcane in Ghana. In this study, 24 triplicates sugarcane stems (sugarcane juice was extracted), 24 triplicates soil samples and 8 triplicates water samples were collected from sugarcane farms in four communities in Ashanti region of Ghana. Two of the communities were exposed to wastewater while the other two without wastewater contamination served as control. Metals (Pb, Cd, Cr, Cu, and Fe) concentration were determined in the digested samples using Spectra AA 220 flame atomic absorption spectrometer. The Pb concentration in all sugarcane juice samples ranged between 12.65 and 145.0 μg/L. The mean Cu concentration of the sugarcane juice samples varied between 11.28 and 156.00 μg/L. In general, there were decrease in metals investigated in sugarcane juice as you move away from the stream. However, the reduction was more pronounced in the hotspot sampling areas than control sampling areas. The EDI value was 9.76 × 10⁻⁴, 2.94 × 10⁻⁵, 1.09 × 10⁻³, and 9.07 × 10⁻³ (mg/kg-day) for Pb, Cd, Cu, and Fe, respectively. Mean hazard quotient (HQ) for the metals studied ranged from 0.036 (Fe) to 0.286 (Pb). The results of this study indicate that sugarcane is able to grow in soils where some metals are accumulated. High levels of metals were pronounced in sugarcane originating from wastewater polluted soils as those considered in this study. The consumption of normal quantity of sugarcane juice may not present detrimental health concerns through a lifetime based on the metals contents alone.</p

Antimicrobial Resistance of Escherichia coli from Broilers, Pigs, and Cattle in the Greater Kumasi Metropolis, Ghana

Globally, resistance to antimicrobial drugs in food animals is on the rise. Escherichia coli of livestock, though commensal in nature, serves as reservoir for antimicrobial resistance genes with the potential of disseminating them. This study sought to examine the antimicrobial resistance profiles of Escherichia coli in broilers, pigs, and cattle in the Kumasi Metropolis and undertake molecular characterisation of the resistances. Faecal E. coli isolates (n = 48) were obtained from 10 broiler farms, (n = 43) from 15 pig farms, and (n = 42) from cattle from the Kumasi Abattoir using standard bacteriological techniques. The Kirby–Bauer disc diffusion method was employed in testing the sensitivities of 133 E. coli isolates to 15 antimicrobials. All 48 isolates from broilers presented no resistance to amoxicillin/clavulanic acid and ceftiofur. A 100% resistance to meropenem was observed in pig and cattle isolates. Multidrug resistance (MDR) across animal groups was 95.8% (n = 46), 95.3% (n = 41), and 64.3% (n = 27) for broilers, pigs, and cattle, respectively. Twenty-eight isolates presenting phenotypic resistance to aminopenicillins and cephalosporins were screened for the presence of extended-spectrum beta-lactamase (ESBL) genes by PCR. One isolate from poultry and another from cattle tested positive for the blaCTX-M ESBL gene. There were no positives for the blaTEM and blaSHV ESBL genes. Commensal E. coli of food animal origin represents an important reservoir of antimicrobial resistance that transfers resistance to pathogenic and nonpathogenic microbes affecting humans and animals. There is an urgent need to institute routine surveillance for the establishment of the mechanisms and molecular orientation of resistance in these organisms

Antimicrobial Usage in Commercial and Domestic Poultry Farming in Two Communities in the Ashanti Region of Ghana

Poultry farming is a common practice in Ghana. Antibiotics are used, particularly in commercial poultry farming, as growth promoters and to prevent and cure infections. However, there is little information on antimicrobial usage in domestic poultry farming in Ghana. This study aimed to describe antimicrobial usage in commercial and domestic poultry farming. A cross-sectional survey was conducted within the Ashanti region of Ghana including 33 commercial farms and 130 households with domestic poultry farming. The median poultry population on commercial farms was 1500 (IQR: 300–3000) compared with 18 (IQR: 10–25) on domestic farms. The majority (97%, n = 32) of commercial farms used antimicrobials, compared with 43% (n = 56) of the domestic farms. Commercial farmers were 6.1 (CI: 3.2–11.8) times more likely to read and follow instructions on antimicrobials in comparison with domestic poultry keepers. About 11% of domestic and 34% of commercial farmers had received education on antimicrobial usage. None of the commercial farmers used herbal remedies; however, 40% (n/N = 52/130) of domestic farmers administered herbs. The misuse of antimicrobials in domestic poultry production calls for stricter regulations and training to limit the emergence and spread of antimicrobial-resistant bacteria among poultr

Salmonella enterica in farm environments in the Ashanti Region of Ghana

Abstract Background Salmonella enterica are important foodborne pathogens and the third leading cause of death among diarrheal infections worldwide. This cross-sectional study investigated the frequency of antibiotic-resistant Salmonella enterica in commercial and smallholder farm environments in the Ashanti Region of Ghana. A total of 1490 environmental samples, comprising 800 (53.7%) soil (from poultry, pigs, sheep, goats and cattle farms), 409 (27.4%) pooled poultry fecal and 281 (18.9%) dust (from poultry farms) samples, were collected from 30 commercial and 64 smallholder farms. All samples were processed using standard culture methods. Isolates were identified by biochemical methods and confirmed using the VITEK 2 System. Antibiotic susceptibility testing was carried out by disk diffusion following the EUCAST guidelines. Serotyping was performed using the Kauffman White Le Minor Scheme. Results The overall Salmonella frequency was 6.0% (n/N = 90/1490); the frequency varied according to the type of sample collected and included: 8.9% for dust (n/N = 25/281), 6.5% for soil (n/N = 52/800) and 3.2% for pooled poultry fecal samples (n/N = 13/409). Salmonella was also recovered from commercial farm environments (8.6%, n/N = 68/793) than from smallholder farms (3.2%, n/N = 22/697) (PR = 2.7, CI: 1.7 – 4.4). Thirty-four different Salmonella serovars were identified, the two most common being Rubislaw (27.8%, n/N = 25/90) and Tamale (12.2%, n/N = 11/90). Serovar diversity was highest in strains from soil samples (70.6%, n/N = 24/34) compared to those found in the dust (35.2%, n/N = 12/34) and in fecal samples (29.4%, n/N = 10/34). Salmonella frequency was much higher in the rainy season (8.4%, n/N = 85/1007) than in the dry season (1.0%, n/N = 5/483) (PR = 8.4, 95% CI: 3.3 – 20.0). Approximately 14.4% (n/N = 13/90) of the isolates were resistant to at least one of the tested antimicrobials, with 84.6% (n/N = 11/13) being resistant to multiple antibiotics. All Salmonella Kentucky (n = 5) were resistant to ciprofloxacin. Conclusion This study showed that farm environments represent an important reservoir for antibiotic-resistant Salmonella, which warrants monitoring and good husbandry practices, especially in commercial farms during the rainy season, to control the spread of this pathogen

Prevalence and Antibiotic Resistance in Campylobacter spp. Isolated from Humans and Food-Producing Animals in West Africa: A Systematic Review and Meta-Analysis

Campylobacter species are one of the leading causes of gastroenteritis in humans. This review reports on the prevalence and antibiotic resistance data of Campylobacter spp. isolated from humans and food-producing animals in West Africa. A systematic search was carried out in five databases for original articles published between January 2000 and July 2021. Among 791 studies found, 38 original articles from seven (41%) out of the 17 countries in West Africa met the inclusion criteria. For studies conducted in food-producing animals, the overall pooled prevalence of Campylobacter spp. was 34% (95% CI: 25&ndash;45). The MDR prevalence was 59% (95% CI: 29&ndash;84) and half (50%, 13/26) of the animal studies had samples collected from the market. The human studies recorded a lower pooled prevalence of Campylobacter spp. (10%, 95% CI: 6&ndash;17), but a considerably higher rate of MDR prevalence (91%; 95% CI: 67&ndash;98). The majority (85%, 11/13) of the human studies took place in a hospital. Campylobacter jejuni and Campylobacter coli were the most common species isolated from both animals and humans. Our findings suggest that Campylobacter spp. is highly prevalent in West Africa. Therefore, improved farm hygiene and &lsquo;One Health&rsquo; surveillance systems are needed to reduce transmission