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PreprintCited by 15Antibiotic Use and ResistanceAntibiotic Resistance in BacteriaAntimicrobial Resistance in Staphylococcus

Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana

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Krumkamp, Ralf, Oppong, Kwabena, Hogan, Benedikt, Strauss, Ricardo, Frickmann, Hagen, Wiafe-Akenten, Charity, Boahen, Kennedy, Rickerts, Volker +9 more·2020
DOI 10.21203/rs.3.rs-16528/v1
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Abstract

Background: Chronic infected wounds are generally difficult to manage and treatment can be particularly challenging in resource-limited settings where diagnostic testing is not readily available. In this study, the epidemiology of microbial pathogens in chronically infected wounds in rural Ghana was assessed to support therapeutic choices for physicians.Methods. Culture-based bacterial diagnostics including antimicrobial resistance testing were performed on samples collected from patients with chronic wounds at a hospital in Asante Akim North Municipality, Ghana. Fungal detection was performed by broad-range fungal PCR and sequencing of amplicons. Results: In total, 105 patients were enrolled in the study, from which 207 potential bacterial pathogens were isolated. Enterobacteriaceae (n=84, 41%) constituted the most frequently isolated group of pathogens. On species level, Pseudomonas aeruginosa (n=50, 24%) and Staphylococcus aureus (n=28, 14%) were predominant. High resistance rates were documented, comprising 29% methicillin resistance in Staphylococcus aureus as well as resistance to 3 rd generation cephalosporins and fluoroquinolones in 33% and 58% of Enterobacteriaceae, respectively. One Pseudomonas aeruginosa strain with carbapenem resistance was identified. The most frequently detected fungi were Candida tropicalis.Conclusions: The pathogen distribution in chronic wounds in rural Ghana matched the internationally observed patterns with a predominance of Pseudomonas aeruginosa and Staphylococcus aureus. Very high resistance rates discourage antibiotic therapy but suggest an urgent need for microbiological diagnostic approaches, including antimicrobial resistance testing to guide the management of patients with chronic wounds in Ghana.

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  • Enterococcus showed high resistance prevalence of 100% to tetracycline and trimethoprim-sulfamethoxazole.

    “Enterococcus showed high resistance prevalence of 100% to tetracycline [25,31], and trimethoprim-sulfamethoxazole [31].”

    From A Systematic Review on Antimicrobial Resistance in Ghana from a One Health Perspective (2024) · cites this paper as [25]

    Table 2 (section labeled Conclusions; page unavailable) reports 12/12 (100%) tetracycline resistance in Enterococcus faecalis. Its trimethoprim-sulfamethoxazole (SXT) entry is internally inconsistent: it reads 12/12 (58%), so the stated 100% prevalence for that antibiotic is not unambiguously supported. (LLM, conf=0.87)

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Authors
Krumkamp, R., Oppong, K., Hogan, B., Strauss, R., Frickmann, H., Wiafe-Akenten, C., Boahen, K., Rickerts, V., McCormick, I., Groß, U., Schulze, M., Jaeger, A., Loderstädt, U., Sarpong, N., Owusu-Dabo, E., May, J., & Dekker, D.
Affiliations
  • Bernhard Nocht Institute for Tropical Medicine (DE)
  • Kumasi centre for collaborative research
  • Robert Koch Institute (DE)
  • Robert Koch Institut
  • Universitätsmedizin Göttingen (DE)
  • Kumasi centre for collaborative reserarch
Corresponding author
Dekker, Denise
ORCID
Publisher
Research Square Platform LLC
Published
2020-03-10
DOI
10.21203/rs.3.rs-16528/v1
OpenAlex
W4248481095
Cited by
15
References
2
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 1
Type
posted content
Language
en
Open access
Licence
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
Keywords
chronic wounds, antibiotic resistance, antimicrobial resistance, Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacteriaceae, methicillin resistance, carbapenem resistance, Candida tropicalis, fungal pathogens, rural hospitals, resource-limited settings

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