BackgroundFilarial pathologies such as lymphedema may be associated with complications such as chronic non-healing wounds. Nonetheless, the role of bacterial population colonizing the lymphedematous legs has been posited to worsen the conditions of those living with the infection. These bacteria are usually composed of staphylococcal species partly because they are commensals. Thus, this present study sought to type the methicillin-resistant Staphylococcus aureus (MRSA) prevalence among individuals presenting with filarial lymphedema, particularly as MRSA tends to affect treatments options.MethodsWe recruited individuals (n = 321) with stages I–VII of lymphedema in a cross-sectional study in the Ahanta West district of the Western Region of Ghana. Swabs from lymphedematous limb ulcers, pus, and cutaneous surfaces were cultured using standard culture-based techniques. The culture isolates were later identified using Matrix-assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) mass spectrometry.ResultsA total of 192 Staphylococci species were isolated, with an overall prevalence of 39.7% (95% CI: 35%–44%; N = 483). S. hominis was the most prevalent species (23.95%), followed by S. haemolyticus (20.83%), S. epidermidis (15.10%), S. aureus (10.41%), and S. saprophyticus (9.32%). The remaining 20.34% were distributed among S. wanneri, S. sciuri, S. pasteuri, S. xylosus, S. simulans, S. cohnii, S. caprae, S. lugdunensis, and S. capitis. MRSA, containing mecA gene, was detected in 21 out of 31 Staphylococci isolates tested, with an overall prevalence of 68% (95% CI: 51%–84%). In addition, a virulent gene, Panton–Valentine leukocidin (PVL), which is usually associated with S. aureus, was detected in 20/31 (64.5%) S. aureus in the study.ConclusionThese results suggest that MRSA species may pose a challenge to the treatment of filarial lymphedema with antibiotics particularly, as doxycycline is currently being piloted in some endemic areas to treat the infection. Thus, intensive antimicrobial resistance surveillance should be conducted in endemic areas by health authorities to forestall the dilemma of multidrug resistance not only against lymphatic filariasis (LF) infection but other diseases.

Introduction. Antimicrobial resistance is a growing international problem resulting from the enzyme β-lactamase production by bacteria, to degrade antibiotics, especially β-lactam antibiotics. In Brong Ahafo Regional Hospital, Sunyani, these antibiotics are heavily depended upon for the treatment of serious infections, but unfortunately high proportions of bacterial isolates in the hospital, have been found to be resistant to the commonly prescribed antibiotics. This study aims to determine the prevalence of ESBL-producing E. coli so as to determine if ESBL are responsible for the high antimicrobial resistance seen at the Brong-Ahafo Regional Hospital, Sunyani. Methods. The study was a cross sectional study, involving 51 E. coli isolates from urine samples of both in-and out-patients between January and December, 2014. Antimicrobial susceptibility profiles of the isolates were determined by the Kirby Bauer disc diffusion method against 12 antibiotics. The isolates were screened for ESBL production, and then confirmed by the combined disc method. The isolates were tested for the presence of ESBL blaCTX-M and blaTEM by conventional PCR. Results. Non-repeat 1,302 midstream urine samples were cultured from which 200 different pathogens were isolated. Of the 200 isolates 51 were E. coli. Isolates obtained from Community isolates were 16(37.2) and isolates from in-patients were 27(62.8). Resistant strains were detected to all the 12 antimicrobials tested. Low proportions were sensitive to cephalosporins (cefotaxime and ceftazidime), both recording 8/51(15.7%), and quinolones (nalidixic acid and ciprofloxacin), 7/51(13.7%) and 8/51(15.7%) respectively. The isolates had varied susceptibility to aminoglycosides, with European Scientific Journal March 2017 edition vol.13, No.9 ISSN: 1857 -7881 (Print) e -ISSN 1857 366 low sensitivity of 1/32(2.0%) to gentamicin, but a high proportion of 47/51(92.2%) was sensitive to amikacin. High proportion of the isolates [43/51(84.3%)] were ESBL phenotype, and was found to be significantly associated (p<0.001) with antimicrobial resistance among the isolates. The most prevalent ESBL genotype was BlaTEM with 26 (66.7%) and blaCTX-M 28(71.8%), but 9(23.1%) ESBL phenotypes tested negative for both blaTEM and blaCTX-M genes. 22 (56.4%) of the isolates had both blaTEM and blaCTX-M genes. Conclusion. High proportions of E. coli isolates from urine in Sunyani produce ESBLs. Both blaTEM and blaCTX-M were prevalent and linked to the high levels of drug resistance found in the locality. Increased antibiotic stewardship and stringent infection control measures along with the testing for ESBL must be instituted in the hospital.

Background: Lymphatic Filariasis (LF), a neglected tropical disease, has been speculated to be complicated by secondary bacteria, yet a systematic documentation of these bacterial populations is lacking. Thus, the primary focus of this study was to profile bacteria diversity in the progression of filarial lymphedema among LF individuals with or without wounds.Methods: A cross-sectional study design recruited 132 LF individuals presenting with lymphedema with or without wounds from eight communities in the Ahanta West District in the Western Region, Ghana. Swabs from the lymphedematous limbs, ulcers, pus, and cutaneous surfaces were cultured using standard culture-based techniques. The culture isolates were subsequently profiled using Matrix-assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry.Results: Of the 132 LF participants recruited, 65% (85) had filarial lymphedema with no wounds. In total, 84% (235) of the bacterial isolates were identified. The remaining 16% (46) could not be identified with the method employed. Additionally, 129(55%) of the strains belonged to the phylum Firmicutes, while 61 (26%) and 45 (19%) represented Proteobacteria and Actinobacteria, respectively. Generally, irrespective of the samples type (i.e., wound sample and non-wound samples), there was a sharp increase of bacteria diversity from Stages 1 to 3 and a drastic decrease in these numbers by Stage 4, followed by another surge and a gradual decline in the advanced stages of the disease. The Shannon Diversity Index and Equitability for participants with and without wounds were (3.482, 0.94) and (3.023, 0.75), respectively. Further, Staphylococcus haemolyticus and Escherichia coli showed resistance to tetracycline, chloramphenicol, and penicillin.

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