Distribution and Antimicrobial Resistance Profiles of Bacterial Aetiologies of Childhood Otitis Media in Accra, Ghana

Abstract

Background: Otitis media (OM), also known as middle ear infection, is a clinically significant childhood disease. In sub-Saharan Africa, there is a paucity of contemporary reports on it is bacterial aetiologies and antimicrobial resistance among them. Aim: To investigate the OM bacterial aetiologies and their antimicrobial resistance patterns among children visiting the Ear, Nose, and Throat clinics of 3 healthcare facilities in Accra, Ghana – Princess Marie Louise Children’s Hospital, 37 Military Hospital, and Mamprobi Hospital. Methods: This cross-sectional study involved 100 children below 13 years old with suppurative otitis media. Following standard bacteriological methods, sterile ear swabs were used to take middle ear discharges from the study participants for culture and antimicrobial susceptibility testing. A standard questionnaire was also used to collect data on socio-demographic and clinical characteristics. Results: The major OM bacterial aetiologies were Pseudomonas aeruginosa (38.5%), Klebsiella pneumoniae (19.8%), Proteus mirabilis (11.5%), and Staphylococcus aureus (10.4%). The majority of the bacteria demonstrated low to moderate resistance (0%-33.3%) to most of the antibiotics. Eight of the bacteria (4 each of Klebsiella pneumoniae and Escherichia coli) were extended-spectrum beta-lactamase (ESBL) producers; 6 ampicillinase (Amp C)-producing organisms (4 Citrobacter spp. and one each of Morganella morganii and Serratia marcescens) were also identified, and they showed high antibiotic resistance. Conclusions: The predominant OM aetiologies were Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus, and they were generally susceptible to most of the antibiotics tested. Amikacin, cefepime, ciprofloxacin, and meropenem could be valuable in the empirical management of childhood OM.

Bacterial etiologies, antimicrobial susceptibility profiles and associated factors among patients with otitis media referred to Nekemte Public Health Research and Referral Laboratory Center, Western Ethiopia: A prospective cross-sectional study

“…This finding is similar to that of study performed in Dessie, Ethiopia, which reported 89.4% (28) but it was higher than that of studies done in Gondar (76.7%) and Bahir Dar (80.4%) (14,29). In contrast, the current culture positivity rate was lower than that studies performed in Ghana (97%) and India (95.7%) (30,31), which may be related to variations in the availability of isolation and identification media. This may be correlated with the fact that availability of relevant media and other supplies maximizes the frequency of culture positivity in middle ear discharge.…”

“…Studies from other parts of Ethiopia used different antibiotics and reported varying susceptibility patterns (25,35). Studies from other parts of the world tested different antibiotics with varying susceptibility patterns (30,36,44) with one of the studies (30) that tested piperacillin-tazobactam, ciprofloxacin and ceftazidime, which were also tested in this study. The use of different antibiotics in different studies is attributed to the occasional emergence of resistant strains from time to time, the availability of proposed antibiotics and local prescribing practices.…”

Extended-spectrum beta-lactamases in clinical isolates of Escherichia coli and Klebsiella pneumoniae recovered from patients at the Tamale Teaching Hospital, Ghana

“…The high antibiotic resistance levels recorded in the present study (in which the isolates investigated were collected nearly eight years ago) are similar to those observed among Enterobacterales in several other studies conducted in Ghana, both older [11,13,24], and newer ones [32][33][34][35][36][37]. That the high AMR levels observed in this study are similar to those in these newer studies [32][33][34][35][36][37] suggests that the AMR situation in the country has been sustained, or possibly been exacerbated over the period, and could probably get worse. A meta-analysis may be needed to quantify the dynamics in the AMR problem in the country in the last decade or two; this could be done in other regions noted as hotspots for AMR occurrence.…”

Phenotypic and genotypic detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in Accra, Ghana

“…Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are two of the major gutcolonizing Gram-negative bacilli of the Enterobacterales implicated in meningitis, infections of the gastrointestinal and urinary tracts, septicaemia, and other infections, most of which are multidrug resistant (MDR) [1][2][3][4][5]. Such resistance traits have a global distribution, and threaten the efficacy of antibiotics [6][7][8][9].…”