Oropharyngeal carriage of potential meningitis-causing bacteria in a Ghanaian prison

Abstract

Background: Bacterial meningitis continues to be a global health problem even after introducing of meningococcal and pneumococcal vaccines. Surveillance of high-risk populations such as prisoners is necessary for timely identification of outbreaks and prophylaxis. This study assessed pharyngeal colonisation of prisoners and officers in a Ghanaian prison with meningitis-causing bacteria. Methods: A cross-sectional study was conducted from January to April 2018. Oropharyngeal swabs were collected, and microbiological and antimicrobial susceptibility analyses were performed. Results: There were 205 participants. Carriage of meningitiscausing bacterial was 102 (49.7%), 8 (3.9%) and 1(0.48%) for Neisseria species (spp.), Staphylococcus aureus (S. aureus) and Streptococcus pneumoniae (S. pneumoniae), respectively and with a total carriage of 52.2% (107/ 205). Four individuals (1.9%) carried both Neisseria spp. and S. aureus. The S. aureus isolates were resistant to ampicillin (87.5%), chloramphenicol (87.5%), and penicillin (87.5%) and sensitive to cefoxitin (100%) cotrimoxazole (87.5%), clindamycin (87.5%), ciprofloxacin (75.0%), oxacillin (75.0%), and erythromycin (62.5%). None of the S. aureus isolated was methicillin resistant. The S. pneumoniae isolated was resistant to cotrimoxazole, tetracycline, and penicillin and sensitive to chloramphenicol, erythromycin, and clindamycin. Education (OR = 1.910, 95% CI 1.029 -3.545, p = 0.040) and years of incarceration (OR = 3.808, 95% CI 1.350 -10.739, p = 0.011) were associated with carriage of meningitis-causing bacteria. Conclusion:This study showed carriage of potential meningitis-causing bacteria in a Ghanaian prison. Multivalent meningococcal conjugate vaccine is key to controlling meningococcal disease outbreaks.