Occurrence and distribution of extended-spectrum β-lactamase in clinical Escherichia coli isolates at Ho Teaching Hospital in Ghana.

Abstract

Objective: This study determined the occurrence and distribution of Extended Spectrum β-Lactamase (ESBL) genotypes of E. coli isolates in Ho Teaching Hospital, Ghana.Design: A cross-sectional study.Setting: A single centre study was conducted at Ho Teaching Hospital of Ghana.Participants: Patients who visited Ho Teaching Hospital Laboratory with the request for culture and susceptibility testing.Main outcome measure: Escherichia coli were isolated, and Extended-Spectrum β-Lactamase genes were detected.Results: Of the 135 isolates, 56(41.5%,95% CI: 33.1% – 50.3%) were ESBL producers. More males, 14(58.3%), produced ESBL than females, 42(37.8%). The ESBL prevalence was highest among the elderly who were 80 years and above 3(100.0%), with the least prevalence among patients within 50-59 years and 0-9 years age bracket, representing 4(25.0%) and 3(27.3%), respectively. The total prevalence of ESBL was marginally higher among out-patients (41.8% 95% CI: 31.9% - 52.2%) compared to in-patients [40.5% 95% CI: 24.8% - 57.9]. BlaTEM-1 was the predominant ESBL genotype obtained from 83.9% (47/56) of the confirmed ESBL producing isolates, with the least being TOHO-1 4(7.1%). The co-existence of 2 different ESBL genes occurred in 19(33.9%) of the isolates. The single and quadruple carriage were 16(28.6%) and 3(5.4%), respectively. The highest co-existence of the ESBL genotypes was recorded for blaTEM-1 and blaCTXM-1 15(26.8%), followed by blaTEM-1, blaCTXM-1 and blaSHV-73 [12(21.4%)].Conclusion: The high prevalence of ESBL-producing E. coli isolates with multiple resistant gene carriage is a threat to healthcare in the study area.

Genotypic characterization of extended-spectrum β-lactamase producing urinary isolates among pregnant women in Ho municipality, Ghana

“…Elsewhere, ESBL prevalence of 50% from northwestern Nigeria [ 12 ], 42% in Lagos, Nigeria [ 36 ], South Africa (36.1%) [ 13 ], Tunisia (38.5%) [ 14 ], and Tanzania (15%) [ 33 ] was reported. The ESBL genotypes obtained in Ho Municipality among the pregnant women were similar to those obtained in Accra [ 9 ] and a much earlier study that recorded an ESBL prevalence of 41.5% at the Ho Teaching Hospital [ 11 ]. In the present study, the prevalence of Bla TEM was 45 (71.4%), Bla CTX-M 42 (66.7%), and Bla SHV 2 (3.2%).…”

“…This means that there is high prevalence of community-acquired ESBL circulating in the Ho Municipality. The high ESBL prevalence observed in this study holds the potential to result in significant treatment failure and the narrowing of the antibiotic spectrum due to its destructive effect on cephalosporins [ 11 ]. Meanwhile, when we consider the growing level of self-medication in our communities without prior laboratory investigation coupled with the difficulty in detecting ESBLs and the inconsistencies in reporting ESBLs within the community, we fear a surge in antibiotic resistance moving forward and the consequences among pregnant women may be dire.…”

“…Prevalence of Enterobacteriaceae strains producing ESBLs varies widely internationally and as well as within the same country depending on the degree of use of the antibiotic in that locality [ 7 , 8 ]. In Ghana, ESBL prevalence of 50.5% in Accra [ 9 ], 57.8% in Kumasi [ 10 ], and 41.5% at the Ho Teaching Hospital [ 11 ] were reported. Elsewhere, ESBL prevalence of 50% in northwestern Nigeria [ 12 ], 36.1% in South Africa (36.1%) [ 13 ], and 38.5% in Tunisia (38.5%) have been documented [ 14 ].…”

Recent Trends in Biosensors for Quinolone Detection: A Comprehensive Review

“…In a recent study, Deku and colleagues investigated the burden of bacteria specifically resistant to four fluoroquinolones at the Ho Teaching Hospital in Ghana. They found that 90 out of 135 Escherichia coli isolates were resistant to at least one of the four fluoroquinolone drugs investigated [39].…”

Molecular Study of Enteropathogenic Escherichia Coli Isolation From Clinical Samples

“…In particular, in certain geographical markets, for example in some certain developing countries, infections caused by E. coli diarrheal have been transferred through human contacts, like enteroaggregative E. coli (EAggEC), endemic [8].Furthermore, the treatment with human manures is frequentlyunusable or levellacking. Therefore, it principals to a wide spreading of these pathogens in the surrounding environment and then they might have contact with Shiga toxin-producing E. coli (STEC).We examined the presence of pathogenic E. coli, mainly entropic ones, in specimens isolated from infant clinical specimens [9].Molecular characterization has manifested high degree of diversity among virulence factors in different strains of atypical EPEC [10].The pathogenicity of degree of extraintestinal E. coli isolates is dependent on the existence of fimbriae adhesions (fimA, sfa/foc, and yfcV) which are documented as very important factors that are responsible for the related adherence [11].…”