BackgroundThis study was designed to investigate whether household cockroaches harbor cephalosporin-resistant enterobacteria that share resistance determinants with human inhabitants. From February through July 2016, whole cockroach homogenates and human fecal samples from 100 households were cultured for cephalosporin-resistant enterobacteria (CRe). The CRe were examined for plasmid-mediated AmpC, ESBL, and carbapenemase genes; antibiotic susceptibility patterns; and conjugative transfer of antibiotic resistance mechanisms. Clonal associations between CRe were determined by multi-locus sequence typing (MLST).ResultsTwenty CRe were recovered from whole cockroach homogenates from 15 households. The prevalence of households with cockroaches that harbored CRe, AmpC- (based on phenotype, with no identifiable blaAmpC genes), ESBL-, and carbapenemase-producers were 15, 4, 5%(2 blaCTX-M-15/TEM-1; 1 blaCTX-M-15/TEM-4; 1 blaTEM-24; 1 blaSHV-4) and 3%(2 blaNDM-1 genes and 1 blaOXA-48 gene), respectively. Overall, 20 CRe were recovered from 61 fecal samples of inhabitants from all 15 households that had cockroach samples positive for CRe. Of these, 5CRe (1 per household) were positive for ESBLs (blaTEM-24, blaTEM-14, blaCTX-M-15/TEM-4, blaSHV-3, blaCTX-M-15/TEM-1) and none carried AmpCs or carbapenemases. From 4% of households, the pair of cockroach and human CRe shared the same sequence type (ST), clonal complex (CC), antibiogram, and conjugable bla gene sequence (house 34, E. coli ST9/CC20-blaTEM-4; house 37, E. coli ST44/CC10-blaCTX-15/TEM-4; house 41, E. coli ST443/CC205-blaCTX-15/TEM-1; house 49, K. pneumoniae ST231/CC131-blaSHV-13).ConclusionThe findings provide evidence that household cockroaches may carry CTX-M-15-, OXA-48- and NDM-1-producers, and share clonal relationship and beta-lactam resistance determinants with humans.

BackgroundThere is little data on Trichomonas vaginalis infection in Ghana. This study evaluated the prevalence of trichomoniasis using different diagnostic methods and determined the risk factors for infection in patients.MethodsA structured questionnaire was administered. Vaginal swabs, urethral swabs and urine specimens were obtained from consenting patients; and the samples processed following standard protocols. The presence of T. vaginalis was determined using wet mount microscopy and polymerase chain reaction (PCR) as gold standard. We also assessed the diagnostic performance the JD’s Trichomonas V® rapid antigen test to inform clinical practice.ResultsThe PCR assay detected T. vaginalis positivity in 64 of 150 patients (42.6, 95%CI:35.0, 50.6) including all positive samples of wet mount microscopy and JD’s Trichomonas V® test. Wet mount microscopy showed low sensitivity (31.6%), high specificity (100%), moderate positive predictive value (75.0%), moderate positive likelihood ratio (3.0), and weak agreement (Cohen’s kappa, 0.283) with PCR assay. The JD’s Trichomonas V® test displayed lower sensitivity (25.0%), specificity (83.3%), and weaker measure of agreement (Cohen’s kappa, 0.233) with PCR. In multivariate analysis, the strongest independent predictor for T. vaginalis was female gender [adjusted odds ratio (AOR), 24.89; 95% confidence interval (CI): 10.58, 51.21; P-value< 0.001]. Knowledge of STI showed a protective effect against infection with the parasite (AOR, 0.13; 95%CI: 0.07, 0.29; P-value< 0.017).ConclusionThe sensitivity of wet mount microscopy was low for T. vaginalis screening in our region. The JD’s Trichomonas V® test should not be considered as an alternative test. We recommend mandatory PCR assay for confirmation of negative wet mount results.

Background Trichomonas vaginalis (TV) infection is the most prevalent non-viral sexually transmitted pathogen worldwide. Among pregnant women, the infection may cause adverse birth outcomes such as premature rupture of membranes and premature labour. In view of the paucity of information relating to TV among Ghanaian pregnant women, this study investigated its prevalence and associated co-infections among pregnant women.MethodsHigh vaginal swabs were obtained from 99 pregnant women using sterile cotton swab sticks. Wet preparation, Grams staining, culturing, coagulase and sensitivity testing were carried out to determine the presence of TV and associated microorganisms.ResultsThe prevalence of TV among the pregnant women was found to be 20.2% (n = 20). Concurring with Trichomoniasis, 75% (n = 15) of participants had other infections such as Candida with prevalence of 53% (n = 8), Proteus infection - 20% (n = 3), Streptococcus infection - 13% (n = 2) and other GNRs and Gonococci having 7% each (n = 1). Moreover, there was 86.9% (n = 86) prevalence of Staphylococcus spp. among study participants. There was statistically significant correlation between TV and Gonococci infection at a correlation co-efficient of 0.107 (P < 0.05) as well as significant correlation between TV and Proteus spp. at a correlation co-efficient of 0.189 (P < 0.05). TV infection was high (60%) among the most sexually active age group (19 to 29 yrs).ConclusionThere was 20.2% prevalence of TV among the pregnant women presenting at the hospitals, with Gonococci and Proteus infections being statistically significant associated infections.

Aim The complexity of periodontitis in both etiology and progression has raised many questions, necessitating enormous research in recent years. The aim of the present study was to detect the presence of herpes viruses in Ghanaian patients diagnosed with periodontitis. Methods Thirty‐one patients were included in the study; 21 with periodontitis classified into localized chronic, generalized, and aggressive periodontitis, and 10 without the disease were used as controls. Subgingival samples were collected, followed by DNA extraction. Multiplex polymerase chain reaction was used to amplify viral DNA for the detection of herpes viruses. Data was analyzed using Stata 14. Results The mean age for patients with aggressive periodontitis was 32.2 years (standard deviation [SD]: 8.50), while those for localized chronic periodontitis and generalized chronic periodontitis were 40.6 years (SD: 7.83) and 46.3 years (SD: 12.12), respectively. Viruses were detected only among patients clinically diagnosed with aggressive periodontitis. Of the total number of aggressive periodontitis patients, herpes simplex virus 1 (HSV‐1) and Epstein‐Barr virus (HBV) were found in four (44%) and one (11%), respectively. The mean age for patients found to have HSV‐1 or EBV was 29 years (SD: 6.93). Conclusion We found HSV‐1 and EBV in the subgingival plaque samples of Ghanaian patients clinically diagnosed with aggressive periodontitis. While our finding requires further investigation, the role of HSV in periodontitis, if elucidated, could transform and inform the clinical management of the condition.

2Aim. Household insect pests, including cockroaches, have gained consideration as potential 3 vectors for multidrug resistant pathogens of public health concern. This study was designed to 4 investigate whether household cockroaches share beta-lactam resistance determinants with human 5 inhabitants. 6 Methods. From February through July 2016, 400 cockroaches were systematically collected from 7 100 households. Whole insect homogenates and faecal samples from inhabitants of all included 8 households were cultured for cephalosporin-resistant enterobacteria (CRe). The CRe were 9 examined for AmpC, ESBL, and carbapenemase genes; antibiotic susceptibility patterns; and 10 conjugative transfer of antibiotic resistance mechanisms. Clonal relationships between isolates 11 were determined by multi-locus sequence typing (MLST).12 Results. Twenty CRe were recovered from whole cockroach homogenates of 15 households. Five 13 harbored ESBL genes (2 bla CTX-M-15/TEM-1 ; 1 bla CTX-M-15/TEM-4 ; 1 bla TEM-24 ; 1 bla SHV-4 ), and 3 carried 14 carbapenemase genes (2 bla NDM-1 genes and 1 bla OXA-48 gene)-all of which were transferrable by 15 conjugation to E. coli J53 recipients. There was high clonal diversity with low inter-species 16 similarity regardless of the beta-lactamase gene sequence. From 6 households, the pair of 17 cockroach and human CRe shared the same antibiogram, ST and/or conjugable bla ESBL gene 18 sequence (house 34, E. coli ST9-bla TEM-4 ; house 37, E. coli ST44-bla CTX-15/TEM-4 ; house 41, E. coli 19 ST443-bla CTX-15/TEM-1 ; house 49, K. pneumoniae ST231-bla SHV-13 ).20 Conclusion. The findings highlight household cockroaches as reservoirs of CTX-M-15, OXA-48 21 and NDM-1 genes that share beta-lactam resistance determinants with humans.22 23

Objective: To determine the prevalence of human papillomavirus (HPV) DNA in oral squamous cell carcinoma (OSCC). Methods: A total of 88 OSCC specimens collected between 2006 and 2013 were available for the study. DNA was extracted using formalin-fixed, paraffin-embedded specimens and analysed for the presence of 18 HPV genotypes using a nested polymerase chain reaction using consensus forward primer (GP-E6-3F) and two consensus back primers (GP-E7-5B and GP-E7-6B). Plasmid DNA of HPV 16 and 18 was used as positive controls. Results: HPV DNA was detected in 3 of the 88 samples, a prevalence of 3.4%. Genotypes detected were 16, 18 and 52. Conclusion: The overall prevalence of HPV DNA was 3.4%. Only high-risk genotypes were detected. This low prevalence of high-risk types of HPV suggests that the HPV virus may not have a significant role in the development of oral cancers in Ghana, unlike higher rates described elsewhere in the world, especially in Western countries. Surveillance of future prevalence of HPV and attention to other major risk factors is warranted.