Contribution of Dug-Out Wells to Salmonella Dissemination in Kwaebibirem District of Ghana

Typhoid fever is rare in the developed world, but in Kwaebibirem District of Ghana, Salmonella infections are very common. Typhoid and paratyphoid fevers in addition to gastroenteritis are frequently reported. The reservoir, prevailing Salmonella species and their antimicrobial susceptibility patterns are not known, but in Ghana treatment of these infections are mostly empirical. 464 samples (270 stool and 194 blood) were collected from patients and 188 water samples were collected from different water sources in Kwaebibirem District and cultured for Salmonella at St. Dominic Hospital, Akwatia. Salmonella prevalence of 11.6% (54/464) among patients and 2.7% (5/188) from dug-out wells were obtained. Total viable bacterial count in the water samples averaged 2.56 x103 -1.2 x 1013per milliliter. Five (5) out of 51 (9.8%) dug-out wells yielded Salmonellae upon culture. Typhoidal Salmonellae [11% (6/54)] and 68.6% (38/54) non-typhoidal Salmonellae were isolated from patients. The most affected age group ranged 6-15years with prevalence of 42.6% (23/54). The most frequent isolated was Salmonella Typhi 20% (11/54) followed by Salmonella Enterica, 29.6% (16/54). The Salmonella isolates were all susceptible to the cephalosporins (cefoxitin, cefotaxime, cefepime) the carbapenems (imipenem and meropenem) the quinolones (norfloxacin and ciprofloxacin) and the aminoglycoside (amikacin). Their resistant proportions to other drugs were ampicillin (69.5%), piperacillin (69.5%) and co-trimoxazole (76.3%). Salmonella infections were common in Kwaebibirem District, and home owned dug-out wells posed risk of Salmonella transmission to the people

Contribution of Dug-Out Wells to Salmonella Dissemination in Kwaebibirem District of Ghana

Typhoid fever is rare in the developed world, but in Kwaebibirem District of Ghana, Salmonella infections are very common. Typhoid and paratyphoid fevers in addition to gastroenteritis are frequently reported. The reservoir, prevailing Salmonella species and their antimicrobial susceptibility patterns are not known, but in Ghana treatment of these infections are mostly empirical. 464 samples (270 stool and 194 blood) were collected from patients and 188 water samples were collected from different water sources in Kwaebibirem District and cultured for Salmonella at St. Dominic Hospital, Akwatia. Salmonella prevalence of 11.6% (54/464) among patients and 2.7% (5/188) from dug-out wells were obtained. Total viable bacterial count in the water samples averaged 2.56 x103 -1.2 x 1013per milliliter. Five (5) out of 51 (9.8%) dug-out wells yielded Salmonellae upon culture. Typhoidal Salmonellae [11% (6/54)] and 68.6% (38/54) non-typhoidal Salmonellae were isolated from patients. The most affected age group ranged 6-15years with prevalence of 42.6% (23/54). The most frequent isolated was Salmonella Typhi 20% (11/54) followed by Salmonella Enterica, 29.6% (16/54). The Salmonella isolates were all susceptible to the cephalosporins (cefoxitin, cefotaxime, cefepime) the carbapenems (imipenem and meropenem) the quinolones (norfloxacin and ciprofloxacin) and the aminoglycoside (amikacin). Their resistant proportions to other drugs were ampicillin (69.5%), piperacillin (69.5%) and co-trimoxazole (76.3%). Salmonella infections were common in Kwaebibirem District, and home owned dug-out wells posed risk of Salmonella transmission to the people

Bacterial contamination of donor blood at the Tamale Teaching Hospital, Ghana

Background: Transfusion of bacterially contaminated blood can result in sepsis and will constitute a substantial health burden to the patient. Objective: To assess the level of transfusion related sepsis and the bacterial types responsible for the contamination at the Tamale Teaching Hospital in Ghana. Method: We sampled 80 refrigerated donor blood at the blood bank and cultured them for bacteria. The antimicrobial sensitivities of the isolates were also determined. Results: 14 blood bags representing 17.5% grew isolates of various bacteria. Ten (10) of the 14 isolates were Gram positive cocci representing 71.42% making it the commonest contaminant. 50% of the gram positive cocci were identified to be coagulase negative staphylococci and 21.42% were Staphylococcus aureus . There were 14.28% isolates which were Gram positive rods, and were identified to be Corynebacterium diphtheroids . There were two isolates which were Gram negative rods; one was identified as Escherichia coli and the other one Klebsiella pneumoniae . Sensitivity among the organisms were varied; as all the 14 (100%) of the organisms isolated were sensitive to amikacin, only 14.28% of the coagulase negative staphylococci were sensitive to co-trimoxazole, 28.5% were sensitive to ampicillin, 42.8% were sensitive to cefuroxime and 71.4% were sensitive to ciprofloxacin. Sensitivity to gentamicin was observed to be 85.7% and 28.5% were sensitive to Tetracycline. Only the 10 Gram positive cocci were tested against erythromycin and Cloxacillin; where 70.00% were sensitive to cloxacillin and 90% were sensitive to erythromycin. Conclusion: All the Staphylococcus aureus isolated were resistant to both ampicillin and cotrimoxazole. Potential dangers and consequences of transfusing multidrug resistance bacteria have been discussed

Candida antifungal drug resistance in sub-Saharan African populations: A systematic review

BACKGROUND: Candida infections are responsible for increased morbidity and mortality rates in at-risk patients, especially in developing countries where there is limited access to antifungal drugs and a high burden of HIV co-infection. OBJECTIVES: This study aimed to identify antifungal drug resistance patterns within the subcontinent of Africa. METHODS: A literature search was conducted on published studies that employed antifungal susceptibility testing on clinical Candida isolates from sub-Saharan African countries using Pubmed and Google Scholar. RESULTS: A total of 21 studies from 8 countries constituted this review. Only studies conducted in sub-Saharan Africa and employing antifungal drug susceptibility testing were included. Regional differences in Candida species prevalence and resistance patterns were identified. DISCUSSION: The outcomes of this review highlight the need for a revision of antifungal therapy guidelines in regions most affected by Candida drug resistance. Better controls in antimicrobial drug distribution and the implementation of regional antimicrobial susceptibility surveillance programmes are required in order to reduce the high Candida drug resistance levels seen to be emerging in sub-Saharan Africa.This study was supported by the Research Office of the University of the Western Cape (project registration no. ScRIRC2012/10/72)