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Cited by 142Antibiotic Resistance in BacteriaAntibiotic Use and ResistanceInfections and bacterial resistance

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

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Agyepong, Nicholas, Govinden, Usha, Owusu-Ofori, Alex, Essack, Sabiha Yusuf·2018·Antimicrobial Resistance & Infection Control
DOI 10.1186/s13756-018-0324-2PMC PMC5845144
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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.

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  • E. coli and K. pneumoniae can cause severe infections and have multiple resistance mechanisms, such as extended-spectrum beta-lactamase (ESBL) and carbapenemase production.

    “MDR was commonly observed among members of the Enterobacteriaceae, including E. coli and K. pneumoniae, which can cause severe infections and have multiple resistance mechanisms, such as extended-spectrum beta-lactamase (ESBL) and carbapenemase production [28,66,67].”

    From A Systematic Review on Antimicrobial Resistance in Ghana from a One Health Perspective (2024) · cites this paper as [28]

    The Background identifies E. coli and K. pneumoniae as major causes of multidrug-resistant infections, and Results (Table 4) reports MDR in 89.9% and 94.7% of their isolates, respectively. The Discussion says cephalosporin resistance may suggest ESBL production among Gram-negative bacteria, but does not establish it for either species; it does not report carbapenemase production. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Agyepong, N., Govinden, U., Owusu-Ofori, A., & Essack, S. Y.
Affiliations
  • University of KwaZulu-Natal (ZA)
  • Kwame Nkrumah University of Science and Technology (GH)
Corresponding author
Owusu-Ofori, Alex
ORCID
Venue
Antimicrobial Resistance & Infection Control
Publisher
Springer Science and Business Media LLC
Published
2018-03-09
Volume
7
Issue
1
Pages
37-37
ISSN
2047-2994 (ISSN-L)
DOI
10.1186/s13756-018-0324-2
PMC
PMC5845144
OpenAlex
W2802753509
Cited by
142
References
3
Citations by year
2026: 13 · 2025: 19 · 2024: 9 · 2023: 28 · 2022: 28 · 2021: 18 · 2020: 11 · 2019: 14 · 2018: 2
FWCI
4.25
Type
journal article
Language
en
Open access
Licence
Locations
  • Antimicrobial Resistance and Infection Control (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • University of Kwa-Zulu Natal, South Africa
  • National Research Foundation Incentive Funding for Rated Researchers (85595)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Infections and bacterial resistance
Keywords
multidrug-resistant Gram-negative bacteria, antimicrobial resistance, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter, urinary tract infection, sepsis, wound infection, antimicrobial susceptibility, Komfo Anokye Teaching Hospital, Ghana, nosocomial infections, antimicrobial stewardship, infection control
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Child, Child, Preschool, Female, Ghana, Gram-Negative Bacteria, Hospitals, Teaching, Humans, Infant, Male, Microbial Sensitivity Tests, Middle Aged, Providencia, Tuberculosis, Pulmonary, Urinary Tract Infections, Wound Infection, Bacteremia, Gram-Negative Bacterial Infections, Sepsis, Drug Resistance, Multiple, Bacterial, Young Adult

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