Phenotypic and Genotypic Characterization of Carbapenem-Resistant Gram-Negative Bacilli Pathogens from Hospitals in Ghana

Codjoe, Francis S.; Donkor, Eric S; Smith, Thomas J.; Miller, Keith

doi:10.1089/mdr.2018.0278

Cited by 45 publications

(66 citation statements)

References 34 publications

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“…In addition, we found one carbapenem-resistant Pseudomonas aeruginosa. Carbapenem-resistance is still comparatively rare in Ghana: 2.9% in Gram-negative rodshaped bacteria, predominantly in Pseudomonas aeruginosa and Acinetobacter baumannii [25]. In summary, the observed resistance patterns make any rational antimicrobial therapy challenging, indicating a need for routine diagnostics including antibiotic susceptibility testing.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana

Krumkamp

Oppong

Hogan

et al. 2020

Preprint

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Background: Chronic infected wounds are generally difficult to manage and treatment can be particularly challenging in resource-limited settings where diagnostic testing is not readily available. In this study, the epidemiology of microbial pathogens in chronically infected wounds in rural Ghana was assessed to support therapeutic choices for physicians.Methods. Culture-based bacterial diagnostics including antimicrobial resistance testing were performed on samples collected from patients with chronic wounds at a hospital in Asante Akim North Municipality, Ghana. Fungal detection was performed by broad-range fungal PCR and sequencing of amplicons. Results: In total, 105 patients were enrolled in the study, from which 207 potential bacterial pathogens were isolated. Enterobacteriaceae (n=84, 41%) constituted the most frequently isolated group of pathogens. On species level, Pseudomonas aeruginosa (n=50, 24%) and Staphylococcus aureus (n=28, 14%) were predominant. High resistance rates were documented, comprising 29% methicillin resistance in Staphylococcus aureus as well as resistance to 3rd generation cephalosporins and fluoroquinolones in 33% and 58% of Enterobacteriaceae, respectively. One Pseudomonas aeruginosa strain with carbapenem resistance was identified. The most frequently detected fungi were Candida tropicalis.Conclusions: The pathogen distribution in chronic wounds in rural Ghana matched the internationally observed patterns with a predominance of Pseudomonas aeruginosa and Staphylococcus aureus. Very high resistance rates discourage antibiotic therapy but suggest an urgent need for microbiological diagnostic approaches, including antimicrobial resistance testing to guide the management of patients with chronic wounds in Ghana.

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Section: Discussionmentioning

confidence: 99%

Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana

Krumkamp

Oppong

Hogan

et al. 2020

Preprint

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“…In Ghana, a recent study involving 111 carbapenem-resistant Gram-negative bacteria showed that none of the isolates harbored KPC genes. However, the carbapenemase genes identified were blaNDM-1, blaVIM-1 and blaOXA-48 in A. baumannii, Pseudomonas species, and K. pneumoniae, respectively [78] . In Uganda, a study by Okoche et al [80] found carbapenemase prevalence of 22.4% and 28.6% using phenotypic and genotypic tests.…”

Section: Acquisition Of Multidrug-resistant Organismsmentioning

confidence: 97%

“…In West Africa, Nigeria and Ghana are the leading countries in the region that have documented data regarding CRE [77] . In Nigeria, a study reported carbapenemase prevalence of 33.5% in a hospital setting [6] , and Codjoe [78] reported 12.5% and 15.4% carbapenemase production in E. coli and K. pneumoniae isolates. Ogbolu and Webber [79] identified blaNDM, blaVIM, and blaGES among P. aeruginosa, Proteus spp., K. pneumoniae and E. coli, respectively as the genes responsible for resistance in β-lactam antibiotics in Nigeria.…”

Section: Acquisition Of Multidrug-resistant Organismsmentioning

confidence: 99%

“…Carbapenem resistance genes References Algeria OXA, NDM, KPC and VIM Robin et al [83] Angola NDM and OXA Kieffer et al [84] Egypt OXA Bathoorn et al [73] Gabon NDM Moussounda et al [85] Ghana KPC, NDM, VIM and OXA Codjoe [78] Kenya NDM Poirel et al [81] , Mitgang et al [86] Madagascar NDM and OXA Mitgang et al [86] Mali OXA Sangare et al [87] Nigeria OXA, NDM, GES and VIM Chika et al [39] , Yusuf et al . [77] , Ogbolu and Webber [79] Senegal OXA Mitgang et al [86] Serra Leone OXA, VIM and DIM Mitgang et al [86] South Africa OXA, NDM, KPC, GES and porin Perovic et al [74] , Lowman et al [76] Tanzania OXA, NDM, KPC, VIM and IMP Mushi et al [82] Uganda OXA, KPC, VIM and IMP Okoche et al [80] DIM: Dutch imipenemase, GES: Guiana extended-spectrum carbapenemase, OXA: Oxacillin-hydrolyzing enzyme, KPC: Klebsiella pneumoniae carbapenemases, NDM: New Delhi metallobeta-lactamase, VIM: Verona integron-encoded metallo-β-lactamases, IMP: Imipenem-resistant Pseudomonas K. pneumoniae, P. aeruginosa, and Salmonella in 80 out of 227 isolates and found that 21.6% of the 227 isolates harbored IMP genes (Table 1).…”

Section: Countrymentioning

confidence: 99%

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Epidemiology of Multidrug-resistant Organisms in Africa

Gulumbe¹,

Faggo²

2019

mjima

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Multidrug-resistant organisms/bacteria (MDROs) have significant health implications that either have not been addressed or received only limited attention, especially in resource-constrained settings such as Africa, where access to newer, often costly antibiotics is limited. Acquisition of MDROs has been linked with poorer clinical outcomes and prolonged hospitalization. The evolution and spread of MDROs is influenced by factors such as selective pressure exerted by indiscriminate use of antimicrobials in both agriculture and medicine, lack of prescribing skills and training, lack of access to rapid and reliable diagnostics, suboptimal surveillance, as well as poor implementation and adherence to prevention measures. Reports indicate increased occurrence of MDROs in Africa, including members of Enterobacteriaceae which are often implicated in bloodstream, urinary tract, abdomen, skin and soft tissue infections. However, serious data limitation and underreporting are major hurdles that continue to hinder our understanding of the impact of antimicrobial resistance. In this review, we sought to address this gap by providing up-to-date data on the epidemiology of MDROs across the continent, including data on their prevalence and current detection and prevention methods.

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“…Gram-negative Bacilli (GNB) are implicated in a wide range of diseases, such as pneumonia, meningitis, septicemia, and urinary tract infections [1]. According to China Antimicrobial Resistance Surveillance System (CARSS) monitoring data (http://www.carss.cn/), GNB have been shown to account for 70.6% of the total number of bacteria in hospitals, which are resistant to most available antibiotics and have developed built-in abilities to acquire new ways of resistance [2].…”

Section: Introductionmentioning

confidence: 99%

Characterization of carbapenem non-susceptible Gram-negative Bacilli isolated from the feces of 10,000 inpatients in Southern China

Duan¹,

Li²,

Peng³

et al. 2020

Preprint

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Background Carbapenem non-susceptible Gram-negative bacilli (CNS-GNB) were dominant pathogen causing clinical infections. The human intestine was important reservoir of GNB, but there were few studies to analysis the prevalence of fecal colonization with them. Methods Fecal samples were collected from hosiptal screening test for GNB was conducted by using home-made MacConkey agar. Antimicrobial susceptibility was determined by the automatic microbiology analyzer and drug-resistant genes were characterized by polymerase chain reaction assays and DNA sequencing. The whole genome sequencing were used to analysis the characteristic of genetic structure of the isolates. Results A total of 680 CNS-GNB were collected. Acinetobacter spp. were the dominant species (33.8%) of the 22 genera. Carbapenemase genes were identified in 307 isolates (45.1%), including 206 (30.3%) blaNDM; 51 (7.5%) blaVIM−2, 48 (7.1%) blaIMP, and seven (1.0%) blaKPC−2. The blaNDM genes were first detected in three isolates, Providencia vermicola, Achromobacter spp., and Cupriavidus gilardii. Co-existence of blaVIM and blaIMP genes was detected in five isolates; Achromobacter co-producing VIM and IMP has not been previously reported. The mcr-1 gene was identified in five strains of Acinetobacter and one strain of K. pneumoniae. In addition, we detected seven isolates harboring the blaAFM−1 gene, a novel metallo-β-lactamase gene. This was first genomic analysis of ST11 K. pneumoniae co-producing NDM-5 and mcr-1, which revealed that blaNDM-5 and mcr-1 are located on two different plasmids. The plasmid harboring blaNDM-5, which was composed of a typical IncX3-type backbone, and the mcr-1 gene, was located between an IS30-like element ISApl1 and a PAP2-like encoding gene in the IncHI2-type plasmid. Conclusions the overall prevalence of fecal carriage of CNS-GNB in 10,000 stool samples was 7.45%, and more than half of CNS-GNB produced carbapenemase. Most CNS-GNB cases were associated with infectious disease, multiple hospitalizations, or long-term care, and a high prevalence of underlying disease.

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Phenotypic and Genotypic Characterization of Carbapenem-Resistant Gram-Negative Bacilli Pathogens from Hospitals in Ghana

Abstract: Phenotypic and genotypic characterization of carbapenem-resistant gram-negative bacilli pathogens from hospitals in Ghana. Microbial drug resist.

Cited by 45 publications

References 34 publications

Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana

Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana

Epidemiology of Multidrug-resistant Organisms in Africa

Characterization of carbapenem non-susceptible Gram-negative Bacilli isolated from the feces of 10,000 inpatients in Southern China

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