Antimicrobial Resistance Patterns of Extended Spectrum Β-Lactamase Producing Klebsiellae and E. coli Isolates from a Tertiary Hospital in Ghana

Introduction: High proportions of E. coli and Klebsiellae isolates at Komfo Anokye Teaching Hospital (KATH) have developed resistance to the commonly prescribed antimicrobial drugs, but the cause of which is unknown. Detailed data upon which to advocate control interventions are scanty. This study determined the prevalence of ESBL Klebsiellae and E. coli at KATH, so as to establish the linkage (if any) between ESBL production and drug resistance to antimicrobials drugs at the Komfo Anokye Teaching Hospital. Method: 405 isolates consisting of 156 E. coli strains and 234 Klebsiella pneimoniae and 15 Klebsiella oxytoca were collected and tested for their antimicrobial susceptibility, ESBL production and the ESBL genotypes were determined by PCR. Results: High proportions of isolates were resistant to the β-lactam antibiotics with ampicillin recordeing 391 (91.7%) resistance followed by cefpodoxime 299 (73.8%), cefuroxime 286 (70.6%), ceftriaxone 224 (55.3%) and then cefotaxime 195 (48.1%). Proportion of isolates resistant non β-lactams tested ranged from 61% - 79%. ESBL producers had higher resistance proportions than non-ESBL producers. ESBL prevalence range from 49.4% in E coli, 61.5% in Klebsiella kpeumoniae to 86.7% in Klebsiella oxytoca. ESBL genotypes TEM, CTX-M were found in 151(64.5) isolates while 70(29.9) acquired the three ESBL genotypes. Conclusion: The widespread prevalence of ESBL producing E. coli and Klebsiellae call for immediate intervention strategies to prevent further spread. Training of laboratory personnel on phenotypic testing of ESBLs in addition to training clinical staff and prescribers on ESBL issues are advocated

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