CoChat
Sign Up
Cited by 32Antibiotic Resistance in BacteriaSalmonella and Campylobacter epidemiologyAntibiotic Use and Resistance

Diarrhea-Causing Bacteria and Their Antibiotic Resistance Patterns Among Diarrhea Patients From Ghana

Open access
Afum, Theophilus, Asandem, Diana Asema, Asare, Prince, Asante-Poku, Adwoa, Mensah, Gloria Ivy, Musah, Abdul Basit, Opare, David, Taniguchi, Kiyosi +11 more·2022·Frontiers in Microbiology
DOI 10.3389/fmicb.2022.894319PMC PMC9161929
Open this paper in CoChat — free accountOpen PDF

Abstract

Diarrheal disease remains a major global health problem particularly in children under 5 years and the emergence of antibiotic-resistant strains of causative pathogens could slow control efforts, particularly in settings where treatment options are limited. This surveillance study conducted in Ghana aimed to determine the prevalence and antimicrobial susceptibility profile of diarrhea-causing bacteria. This was a cross-sectional study carried out in five health facilities in the Ga West Municipality of Ghana between 2017 and 2021. Diarrheic stool samples from patients were collected and cultured on standard differential/selective media and isolates identified by standard biochemical tests, MALDI-TOF assay, and serological analysis. The antibiogram was determined using Kirby-Bauer disk diffusion and Microscan autoScan4 MIC panels which were used for extended-spectrum beta-lactamase (ESBL) detection. Bacteria were isolated from 97.5% (772/792) of stool samples, and 167 of the isolates were diarrheagenic and met our inclusion criteria for antimicrobial resistance (AMR) analysis. These included Escherichia coli (49.1%, 82/167), Salmonella species (23.9%, 40/167), Vibrio species (16.8%, 28/167), and Shigella species (10.2%, 17/167). Among 24 Vibrio species, we observed resistances to cefotaxime (21/24, 87.5%), ceftriaxone (20/24, 83.3%), and ciprofloxacin (6/24, 25%), including four multi-drug resistant isolates. All 13 Vibrio parahaemolyticus isolates were resistant to cefazolin. All 17 Shigella isolates were resistant to tetracycline with resistance to shigellosis drugs such as norfloxacin and ciprofloxacin. Salmonella isolates were highly susceptible to norfloxacin (40/40, 100%) and tetracycline (12/34, 35%). Two ESBL-producing E. coli were also identified with marked susceptibility to gentamicin (66/72, 91.7%) and amikacin (57/72, 79.2%) prescribed in the treatment of E. coli infections. This study showed the different bacteria implicated in diarrhea cases in Ghana and the need for differential diagnoses for better treatment outcomes. Escherichia coli , Shigella , Salmonella , and Vibrio have all been implicated in diarrhea cases in Ghana. The highest prevalence was E. coli and Salmonella with Shigella the least prevalent. Resistance to commonly used drugs found in these isolates may render bacteria infection treatment in the near future nearly impossible. Routine antimicrobial susceptibility testing, effective monitoring, and nationwide surveillance of AMR pathogens should be implemented to curb the increase of antimicrobial resistance in Ghana.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3389/fmicb.2022.894319

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • MDR prevalence was 17.6% for Shigella spp., 78.4% for Vibrio cholerae, 88% for K. pneumoniae, 89.5% for P. aeruginosa, and 100% for A. baumannii.

    “MDR prevalence of 17.6%, 78.4%, 88%, 89.5% and 100% were reported for Shigella spp. [17], Vibrio cholerae [26], K. pneumoniae [35], P. aeruginosa [28], and A. baumannii [30], respectively.”

    From A Systematic Review on Antimicrobial Resistance in Ghana from a One Health Perspective (2024) · cites this paper as [17]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 39

  1. Akuffo R. Armah G. Clemens M. Kronmann K. Jones A. Agbenohevi P.. (2017). Prevalence of enteric infections among hospitalized patients in two referral hospitals in Ghana. BMC Res. Notes 10, 1– 7. doi: 10.1186/s13104-017-2621-x, PMID: 28716138 PMC5514524 · DOI
  2. Andoh L. Dalsgaard A. Obiri-Danso K. Newman M. Barco L. Olsen J. (2016). Prevalence and antimicrobial resistance of Salmonella serovars isolated from poultry in Ghana. Epidemiol. Infect. 144, 3288– 3299. doi: 10.1017/S0950268816001126, PMID: 27334298 PMC9150280 · DOI · Paper page
  3. Ashkenazi S. Levy I. Kazaronovski V. Samra Z. (2003). Growing antimicrobial resistance of Shigella isolates. J. Antimicrob. Chemother. 51, 427– 429. doi: 10.1093/jac/dkg080, PMID: 12562716 · DOI
  4. Basnet B. Niroula D. Acharya J. Basnyat S. (2021). Antibiotic susceptibility pattern of Shigella spp. isolated from patients suspected of acute gastroenteritis. J. Instr. Sci. Technol. 26, 1– 7. doi: 10.3126/jist.v26i2.41261 · DOI
  5. Bolinches J. Romalde J. L. Toranzo A. E. (1988). Evaluation of selective media for isolation and enumeration of vibrios from estuarine waters. J. Microbiol. Methods 8, 151– 160. doi: 10.1016/0167-7012(88)90016-4 · DOI
  6. de Melo L. M. R. Almeida D. Hofer E. dos Reis C. M. F. Theophilo G. N. D. Santos A. F.. (2011). Antibiotic resistance of Vibrio parahaemolyticus isolated from pond-reared Litopenaeus vannamei marketed in Natal, Brazil. Braz. J. Microbiol. 42, 1463– 1469. doi: 10.1590/S1517-83822011000400032, PMID: 24031779 PMC3768750 · DOI
  7. Díaz-Jiménez D. García-Meniño I. Herrera A. García V. López-Beceiro A. M. Alonso M. P.. (2020). Genomic characterization of Escherichia coli isolates belonging to a new hybrid aEPEC/ExPEC pathotype O153: H10-A-ST10 eae-beta1 occurred in meat, poultry, wildlife and human diarrheagenic samples. Antibiotics 9: 192. doi: 10.3390/antibiotics9040192, PMID: 32316613 PMC7235894 · DOI
  8. Escribano A. Ørskov I. Ørskov F. Borras R. (1987). Enterotoxigenic Escherichia coli O153: H45 from an outbreak of diarrhoea in Spain. Med. Microbiol. Immunol. 176, 241– 244. doi: 10.1007/BF00190530, PMID: 3309599 · DOI
  9. Gilchrist C. A. Petri S. E. Schneider B. N. Reichman D. J. Jiang N. Begum S.. (2016). Role of the gut microbiota of children in diarrhea due to the protozoan parasite Entamoeba histolytica. J. Infect. Dis. 213, 1579– 1585. doi: 10.1093/infdis/jiv772, PMID: 26712950 PMC4837909 · DOI
  10. Government of Ghana (2015). Ghana weekly epidemiological bulletin [Internet]. Available at: http://www.ghanahealthservice.org/downloads/Weekly_Epid_Bulletin_Week_1_2015.pdf (Accessed May 16, 2021).
  11. Hodges K. Gill R. (2010). Infectious diarrhea: cellular and molecular mechanisms. Gut Microbes 1, 4– 21. doi: 10.4161/gmic.1.1.11036, PMID: 21327112 PMC3035144 · DOI
  12. Jingjit N. Preeprem S. Surachat K. Mittraparp-Arthorn P. (2021). Characterization and analysis of clustered regularly interspaced short palindromic repeats (CRISPRs) in pandemic and non-pandemic Vibrio parahaemolyticus isolates from seafood sources. Microorganisms 9: 1220. doi: 10.3390/microorganisms9061220, PMID: 34199972 PMC8226915 · DOI
  13. Jung S. W. (2018). A foodborne outbreak of gastroenteritis caused by Vibrio parahaemolyticus associated with cross-contamination from squid in Korea. Epidemiol. Health 40: e2018056. doi: 10.4178/epih.e2018056, PMID: 30727702 PMC6367201 · DOI
  14. Junhe L. Baisheng L. Taohua L. Zhaowen P. Miaolin H. Jingwen Z. (2018). Etiological characteristics of Vibrio parahaemolyticus strains isolated from a food poisoning event in Jiangmen, Guangdong. Dis. Surveill. 33, 387– 390. doi: 10.3784/j.issn.1003-9961.2018.05.009 · DOI
  15. Kalule J. B. Smith A. M. Vulindhlu M. Tau N. P. Nicol M. P. Keddy K. H.. (2019). Prevalence and antibiotic susceptibility patterns of enteric bacterial pathogens in human and non-human sources in an urban informal settlement in cape town, South Africa. BMC Microbiol. 19, 1– 11. doi: 10.1186/s12866-019-1620-6, PMID: 31694551 PMC6836408 · DOI
  16. Kennedy C. Walsh C. Karczmarczyk M. O’Brien S. Akasheh N. Quirke M.. (2018). Multi-drug resistant Escherichia coli in diarrhoeagenic foals: pulsotyping, phylotyping, serotyping, antibiotic resistance and virulence profiling. Vet. Microbiol. 223, 144– 152. doi: 10.1016/j.vetmic.2018.08.009, PMID: 30173740 · DOI
  17. Kunadu A. P. H. Holmes M. Miller E. L. Grant A. J. (2018). Microbiological quality and antimicrobial resistance characterization of Salmonella spp. in fresh milk value chains in Ghana. Int. J. Food Microbiol. 277, 41– 49. doi: 10.1016/j.ijfoodmicro.2018.04.025, PMID: 29680695 · DOI
  18. Larbi R. T. Atiglo D. Y. Peterson M. B. Biney A. A. Dodoo N. D. Dodoo F. N. A. (2021). Household food sources and diarrhoea incidence in poor urban communities, Accra Ghana. PLoS One 16: e0245466. doi: 10.1371/journal.pone.0245466, PMID: 33508014 PMC7842991 · DOI
  19. Lompo P. Tahita M. C. Sorgho H. Kaboré W. Kazienga A. Nana A. C. B.. (2021). Pathogens associated with acute diarrhea, and comorbidity with malaria among children under five years old in rural Burkina Faso. Pan. Afr. Med. J. 38: 259. doi: 10.11604/pamj.2021.38.259.15864, PMID: 34104307 PMC8164431 · DOI
  20. Mbuthia O. W. Mathenge S. G. Oyaro M. O. Ng’ayo M. O. (2018). Etiology and pathogenicity of bacterial isolates: a cross sectional study among diarrheal children below five years in central regions of Kenya. Pan. Afr. Med. J. 31: 88. doi: 10.11604/pamj.2018.31.88.15644, PMID: 31011389 PMC6462152 · DOI
  21. Mensah P. Yeboah-Manu D. Owusu-Darko K. Ablordey A. (2002). Street foods in Accra, Ghana: how safe are they? Bull. World Health Organ. 80, 546– 554. 12163918 PMC2567559
  22. Mizutani T. Aboagye S. Y. Ishizaka A. Afum T. Mensah G. I. Asante-Poku A.. (2021). Gut microbiota signature of pathogen-dependent dysbiosis in viral gastroenteritis. Sci. Rep. 11, 1– 11. doi: 10.1038/s41598-021-93345-y, PMID: 34230563 PMC8260788 · DOI
  23. Nath R. Saikia L. Choudhury G. Sharma D. (2013). Drug resistant Shigella flexneri in & around Dibrugarh, north-East India. Indian J. Med. Res. 137, 183– 186. 23481070 PMC3657885
  24. Newman M. J. Frimpong E. Donkor E. S. Opintan J. A. Asamoah-Adu A. (2011). Resistance to antimicrobial drugs in Ghana. Infect. Drug Resist. 4, 215– 220. doi: 10.2147/IDR.S21769, PMID: 22259250 PMC3259688 · DOI
  25. Nkrumah B. Nguah S. B. (2011). Giardia lamblia: a major parasitic cause of childhood diarrhoea in patients attending a district hospital in Ghana. Parasit. Vectors 4, 1– 7. doi: 10.1186/1756-3305-4-163, PMID: 21859463 PMC3170632 · DOI
  26. Noora C. L. Issah K. Kenu E. Bachan E. G. Nuoh R. D. Nyarko K. M.. (2017). Large cholera outbreak in Brong Ahafo region, Ghana. BMC Res. Notes 10: 389. doi: 10.1186/s13104-017-2728-0, PMID: 28797285 PMC5553860 · DOI
  27. Obeng-Nkrumah N. Labi A. K. Blankson H. Awuah-Mensah G. Oduro-Mensah D. Anum J.. (2019). Household cockroaches carry CTX-M-15-, OXA-48-and NDM-1-producing enterobacteria, and share beta-lactam resistance determinants with humans. BMC Microbiol. 19, 1– 11. doi: 10.1186/s12866-019-1629-x, PMID: 31801455 PMC6894353 · DOI
  28. Pourakbari B. Mamishi S. Mashoori N. Mahboobi N. Ashtiani M. H. Afsharpaiman S.. (2010). Frequency and antimicrobial susceptibility of Shigella species isolated in children medical center hospital, Tehran, Iran, 2001-2006. Braz. J. Infect. Dis. 14, 153– 157. doi: 10.1016/S1413-8670(10)70029-5, PMID: 20563441 · DOI
  29. Pun S. B. (2014). The first appearance of classical-like phenotype Vibrio cholerae in Nepal. North Am. J. Med. Sci. 6, 183– 184. doi: 10.4103/1947-2714.131248, PMID: 24843853 PMC4024587 · DOI
  30. Quilici M. L. Massenet D. Gake B. Bwalki B. Olson D. M. (2010). Vibrio cholerae O1 variant with reduced susceptibility to ciprofloxacin, Western Africa. Emerg. Infect. Dis. 16, 1804– 1805. doi: 10.3201/eid1611.100568, PMID: 21029554 PMC3294521 · DOI
  31. Takyi S. A. Amponsah O. Yeboah A. S. Mantey E. (2021). Locational analysis of slums and the effects of slum dweller’s activities on the social, economic and ecological facets of the city: insights from Kumasi in Ghana. GeoJournal 86, 2467– 2481. doi: 10.1007/s10708-020-10196-2 · DOI
  32. Tan C. W. Rukayadi Y. Hasan H. Thung T. Y. Lee E. Rollon W. D.. (2020). Prevalence and antibiotic resistance patterns of Vibrio parahaemolyticus isolated from different types of seafood in Selangor, Malaysia. Saudi J. Biol. Sci. 27, 1602– 1608. doi: 10.1016/j.sjbs.2020.01.002, PMID: 32489301 PMC7253911 · DOI
  33. Tate J. E. Burton A. H. Boschi-Pinto C. Parashar U. D. World Health Organization–Coordinated Global Rotavirus Surveillance Network (2016). Global, regional, and national estimates of rotavirus mortality in children< 5 years of age, 2000–2013. Clin. Infect. Dis. 62, S96– S105. doi: 10.1093/cid/civ1013, PMID: 27059362 PMC11979873 · DOI
  34. Wang J. Zhan Y. Sun H. Fu X. Kong Q. Zhu C.. (2022). Regulation of virulence factors expression during the intestinal colonization of Vibrio parahaemolyticus. Foodborne Pathog. Dis. 19, 169– 178. doi: 10.1089/fpd.2021.0057, PMID: 35085447 · DOI
  35. Wang L. P. Zhou S. X. Wang X. Lu Q. B. Shi L. S. Ren X.. (2021). Etiological, epidemiological, and clinical features of acute diarrhea in China. Nat. Commun. 12, 1– 12. doi: 10.1038/s41467-021-22551-z, PMID: 33927201 PMC8085116 · DOI
  36. Wilcox M. H. (2009). The tide of antimicrobial resistance and selection. Int. J. Antimicrob. Agents 34, S6– S10. doi: 10.1016/S0924-8579(09)70550-3, PMID: 19596111 · DOI
  37. William A. Satija S. Kaur R. (2020). Bacterial etiology of diarrhoea in a tertiary care hospital. Int. J. Recent Sci. Res. 11, 39022– 39024. doi: 10.24327/ijrsr.2020.1106.5426 · DOI
  38. Yang X. Guo Y. Xiao L. Feng Y. (2021). Molecular epidemiology of human cryptosporidiosis in low-and middle-income countries. Clin. Microbiol. Rev. 34, e00087– e00119. doi: 10.1128/CMR.00087-19, PMID: 33627442 PMC8549823 · DOI
  39. Zhou Y. Zhu X. Hou H. Lu Y. Yu J. Mao L.. (2018). Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study. BMC Infect. Dis. 18, 1– 10. doi: 10.1186/s12879-017-2936-1, PMID: 29390982 PMC5796495 · DOI

Cited by

Sorted by citations

Authors
Afum, T., Asandem, D. A., Asare, P., Asante-Poku, A., Mensah, G. I., Musah, A. B., Opare, D., Taniguchi, K., Guinko, N. M., Aphour, T., Arhin, D., Ishikawa, K., Matano, T., Mizutani, T., Asiedu-Bekoe, F., Kiyono, H., Anang, A. K., Koram, K. A., & Yeboah-Manu, D.
Affiliations
  • University of Ghana (GH)
  • Ghana Health Service (GH)
  • Chiba University (JP)
  • Joint Research Center for Human Retrovirus Infection, Kumamoto University (JP)
  • Institute of Medical Science, The University of Tokyo (JP)
ORCID
Venue
Frontiers in Microbiology
Publisher
Frontiers Media SA
Published
2022-05-19
Volume
13
Pages
894319-894319
ISSN
1664-302X (ISSN-L)
DOI
10.3389/fmicb.2022.894319
PMC
PMC9161929
OpenAlex
W4280613241
Cited by
32
References
4
Citations by year
2026: 7 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 1
FWCI
2.05
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Microbiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders
  • Japan Agency for Medical Research and Development
  • Japan International Cooperation Agency
  • Japan Society for the Promotion of Science (18H05280)
  • Science and Technology Research Partnership for Sustainable Development (19jm0110012)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
Keywords
antimicrobial resistance, antimicrobial susceptibility, Escherichia coli, Salmonella, Vibrio parahaemolyticus, Shigella, extended-spectrum beta-lactamase, multidrug resistance, cefotaxime resistance, ceftriaxone resistance, tetracycline resistance, norfloxacin resistance, ciprofloxacin resistance, children under five, Ghana

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review