Antimicrobial-Resistant Bacteria in Infected Wounds, Ghana, 20141

Janssen, Hauke; Janssen, Iryna; Cooper, Paul; Kainyah, Clemens; Pellio, Theresia; Quintel, Michael; Monnheimer, Mathieu; Groß, Uwe; Schulze, Marco H.

doi:10.3201/eid2405.171506

Cited by 28 publications

(30 citation statements)

References 14 publications

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“…In the current study, generally, Pseudomonas aeruginosa was the most common isolated bacteria, this is followed by E. coli, Klebsiella pneumoniae, Proteus mirabilis and Staphylococcus aureus. This observation is in dissimilarity to preceding studies, that indicted Staphylococcus aureus [22,24] and E. coli [25,26] as the most commonly isolated, occurring in frequencies ranging from 26.19% to 88%. Other aerobic species isolated from the infected wounds in the present study as presented in descending order includes: Gram-negative bacilli: Alcaligens spp., Acinetobacter junil, Citrobacter spp., Enterobacter cloacae, Hafnia alvei, Morganella morgani, Providencia rettgeri and Serretia marcescens, while the Gram positive includes: Enterococcus spp., Coagulase negative staphylococcus, Streptococcus pneumoniae, Corynebacterium spp., and Streptococci B, C and G making this list widespread and multifaceted.…”

Section: Discussioncontrasting

confidence: 99%

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Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Abdu

Egbagba

Fente

2019

Trop J Pathol Microbiol

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Introduction: Infected wounds in particular, those associated with antimicrobial resistant microorganisms constitute a significant source of physical, psychological, and economic burden to patients in particular, and the society at large in terms of the huge resources spent in treating such wounds as well as time/days lost at workplaces leading to increased morbidity and mortality globally. The present study sought to investigate and identify the common bacteria associated with wound infections and their antibiotic sensitivity pattern. Material and Methods: A total of 130 wound samples were collected by doctors in ward using Sterile Swab Sticks over a period of 6 months from February-July 2019. Pathogenic bacteria were isolated, identified and their antibiotic susceptibility tests were performed. Results: Among 130 cases, 108 (83.08%) were culture positive for bacterial pathogens, while 22 (16.92%) were bacteriologically sterile (Negative). Rate of infection was high in males (56.15%) than females (43.85%). Of the 108-culture positive, 164 isolates were recovered of which 28 (17.07) were anaerobes, while 136 were aerobes of which 106 (64.64%) were Gram-negative species and 30 (18.29%) Gram-negative species. The predominant isolates among the facultative aerobes, were Pseudomonas aeruginosa 28 (17.07%), followed by E. coli 19 (11.58%), Klebsiella pneumonia 17 (10.37%) while the least were amongst Morganella morgani, Providencia rettgeri and Serretia marcescens with 2 (1.22%) individually. Among the Gram-positive, Staphylococcus aureus 10 (6.10%) were most common, followed by Enterococcus spp 4 (2.44%), Coagulase negative staphylococcus (CoNS) 4 (2.44%) while the least were amongst Streptococcus Group B, Streptococcus Group C, Streptococcus Group G with 2 (1.22%) separately. Amongst the anaerobes, Bacterioides fragilis 16 (9.75%) is the most common, followed by Peptostreptococcus spp., and Prevotella spp with 4 (2.44%) each, while Fusobacterium spp and Veillonella spp were the least, 2 (1.22%) each. Amikacin and nitrofurantoin are the most efficacious for managing wound infections, with all the isolates being susceptible to them. Resistance was moderate to Levofloxacin (49.39%). On the other hand, resistance were above average among Ciprofloxacin (96.34%), Cloxacillin (94.51%), Ceftriaxone (91.46%), Ceftazidine (91.46%), Cefotaxime (87.20%), Erythromycin (59.15%), Ofloxacin (58.54%) and Chloramphenicol (51.22%). The least resistance shown to Gentamicin (16.46%), Streptomycin (16.46%), Imipenem (7.93%), Metronidazole (7.93%), and Piperacillin-tazobactam (7.93%). Conclusion: Antibiotic susceptibility test is suggested prior to administration of antibiotics for successful treatment and intermittent monitoring is also encouraged to check emerging multidrug resistant trends as a guide to health authorities.

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Section: Discussioncontrasting

confidence: 99%

“…However, contrary to our findings, many authors have reported higher level of resistance among infected wound isolates to aminoglycosides [2,22,24,50,51]. Aside from haphazard use of these drugs in those set ups, bacteria are able to resist the action of aminoglycosides via: i).…”

Section: Discussioncontrasting

confidence: 89%

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Abdu

Egbagba

Fente

2019

Trop J Pathol Microbiol

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“…The bacterial spectrum seen was in line with findings from previous studies conducted in another region of Ghana, in Ethiopia and in Tanzania [1,[11][12][13][14][15].…”

Section: Discussionsupporting

confidence: 90%

“…The observed antimicrobial resistance patterns are of interest. The recorded 29% MRSA is in discordance with a Ghanaian study on wound infections from 2014, where no MRSA were identified from infected wounds [14]. This suggests a considerable increase of MRSA within less than a decade;…”

Section: Discussioncontrasting

confidence: 55%

“…although it has to be considered that selection processes in chronic wounds after repeated antimicrobial therapy are likely. High frequencies of 3rd generation cephalosporin and fluoroquinolone resistance but absence of carbapenem resistance in Enterobacteriaceae isolated from wounds in Ghana has, in contrast, been described previously [14]. The increase of fluoroquinolone resistance in Ghana has recently been described [24].…”

Section: Discussionmentioning

confidence: 97%

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

Krumkamp

Oppong

Hogan

et al. 2020

Preprint

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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 3rd 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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Bacterial diversity significantly reduces toward the late stages among filarial lymphedema patients in the Ahanta West District of Ghana: A cross‐sectional study

Asiedu

Kini

Aglomasa

et al. 2022

Health Science Reports

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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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Antimicrobial-Resistant Bacteria in Infected Wounds, Ghana, 20141

Cited by 28 publications

References 14 publications

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a tertiary hospital, Bayelsa, South southern, Nigeria

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

Bacterial diversity significantly reduces toward the late stages among filarial lymphedema patients in the Ahanta West District of Ghana: A cross‐sectional study

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