Diarrhoeagenic E. coli occurrence and antimicrobial resistance of Extended Spectrum Beta-Lactamases isolated from diarrhoea patients attending health facilities in Accra, Ghana

Abstract

Introduction Diarrhoea accounts for high morbidity and mortality in children and adults worldwide. Extended Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL-PE) and Diarrhoeagenic Escherichia coli (DEC) contribute to prolonged hospitalization because of their resistance and virulence properties aiding in the spread of diarrhoeal disease and delayed treatment. Aim To determine DEC and the antimicrobial resistance of ESBL-PE isolated among diarrhoea patients attending two health facilities in Ghana. Methods Stool samples were collected from 122 diarrhoeal patients who attended Maamobi General Hospital and Kaneshie Polyclinic between January 2019 and March 2020. Identification of bacteria was performed by using the Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Using disk diffusion, antimicrobial susceptibility testing (AST) was conducted and interpreted according to the 2018 CLSI guidelines. Detection of ESBL and DEC genes was performed using Polymerase chain reaction (PCR). Results A total of 80.3% (98/122) Enterobacteriaceae was recovered from the patients in the study with an overall ESBL occurrence of 20.4% (20/98), predominantly among E. coli showed 13.2% (10/76), Klebsiella pneumoniae,35.7%(5/14) and Proteus mirabilis, 57.1%(4/7). Among the ESBL genes detected, blaTEM (n = 14) was common, followed by blaCTX-M (n = 13) and blaSHV (n = 4). Thirty-four E. coli isolates possessed the heat labile (Lt) gene of Enterotoxigenic E. coli (ETEC). Conclusion Our findings confirm the existence of DEC and the antimicrobial resistance patterns of ESBL-PE among stool isolates, limiting the options of commonly used drugs for diarrhoeal treatment in Ghana. Routine laboratory testing in health care facilities and strengthened surveillance systems among hospital networks are encouraged for a better understanding of their epidemiology and clinical implications.

An Assessment of the Current Level of Implementation of the Core Elements of Antimicrobial Stewardship Programs in Public Hospitals in Ghana

“…We also believed it was necessary to evaluate the barriers and facilitators of ASPs among hospital in Ghana to guide policies and strategies toward achieving the Ghana NAP goals to fight the rising rate of AMR and its impact on the healthcare system. [43][44][45][46] With respect to the 7 core elements of implementing sustainable ASPs. 15,21 leadership commitment emphasizes the necessity of a health facility having dedicated time, financial and human resources as well as prioritizing AMS activities to enhance appropriate antibiotic use.…”

Exposure to Veterinary Antibiotics via Food Chain Disrupts Gut Microbiota and Drives Increased Escherichia coli Virulence and Drug Resistance in Young Adults

“…The result of LEfSe analysis further demonstrated that E. coli was enriched in HAG. E. coli has been described in many reports for their high resistance to antibiotics [38]. As a result, it is reasonable to deduce that low diversity of gut microbiota and high abundance of Bacteroidetes and Proteobacteria are a biomarker of long-term exposure to VAs and PVAs via the food chain.…”

Genomic characterization of multi drug resistant ESBL-producing Escherichia coli isolates from patients and patient environments in a teaching hospital in Ghana

“…Colonization of hospital patients with ESBL producing E. coli isolates have been reported in African countries such as South Africa, Uganda, and Tanzania [11][12][13]. Recent studies in a Ghanaian hospital reported that about 13.2% of diarrhoegenic E. coli isolates from patients were ESBL positive and cefotaxime resistant ESBL E. coli was found to be widely disseminated in Ghanaian hospitals [14][15][16].…”