Risk of Asymptomatic Bacteriuria among People with Sickle Cell Disease in Accra, Ghana

Donkor, Eric S.; Osei, Jonathan A.; Anim-Baidoo, Isaac; Darkwah, Samuel

doi:10.3390/diseases5010004

Cited by 11 publications

(15 citation statements)

References 29 publications

(46 reference statements)

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“…We observed very high percentage resistance for Piperacillin (87.1%), Amoxicillin+Clavulanic Acid (87.1%), and Nalidixic Acid (71%), which concur with previous studies on antibiotic resistance of uropathogens in Ghana 21,38,42. This raises concerns about the suitability of these antibiotics for empirical treatment of UTI in Ghana.…”

Section: Discussionsupporting

confidence: 89%

“…E. coli , which is the leading causative organism of both community and hospital,6,8,37 was the most predominant organism isolated from the study participants. In Ghana, E. coli was the most common uropathogen isolated from stroke patients,21 sickle cell disease patients,38 and pregnant women 20. In the pathogenesis of UTI, E. coli employs factors such iron acquisition systems, fimbriae that mediate attachment to host tissues, toxins (hemolysins and autotransporter toxins), flagella, and special proteins that help to weaken and aid evasion of the host innate and adaptive immune system 39.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Community acquired urinary tract infections among adults in Accra, Ghana</p>

Donkor¹,

Horlortu²,

Dayie³

et al. 2019

IDR

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Background: Urinary tract infection (UTI) is one of the most common bacterial infectious diseases encountered in clinical practice, and accounts for significant morbidity and high medical costs. To reduce its public health burden, there is the need for local research data to address aspects of prevention and management of UTI. The aim of this study was to investigate community-acquired UTI among adults in Accra, Ghana, including the risk factors, etiological agents, and antibiotic resistance. Methods: This was a cross-sectional study involving 307 patients clinically diagnosed with UTI at the Korle Bu and Mamprobi polyclinics in Accra. Urine specimens were collected from the study participants and analyzed by culture, microscopy, and dipstick. The bacterial isolates were identified using standard microbiological methods and tested against a spectrum of antibiotics by the Kirby Bauer method. Multidrug resistant Enterobacteriaceae isolates were screened for Extended Spectrum β-lactamase (ESBL) production by the double disc method, and isolates that tested positive were analyzed by Polymerase Chain Reaction for ESBL genes. Demographic information and clinical history of study participants were collected. Results: Based on the criteria for laboratory confirmed UTI, 31 (10.1%) of the 307 specimens were positive and the main risk factor of UTI among the study participants was pregnancy ( P =0.02, OR=2.43). The most common uropathogen isolated was Escherichia coli (48.9%), followed by Klebseilla sp. (16.1%). Prevalence of resistance was highest for Piperacillin (87.1%) and Amoxicillin+Clavulanic Acid (87.1%) and lowest for Amikacin (12.9%). Prevalence of multidrug resistance among the uropathogens was 80.1% (25) and the most common ESBL gene detected was CTX-M-15. Conclusion: Pregnant women constitute the key risk population of UTI in Accra, while Amikacin remains a suitable drug for the treatment of febrile UTI. The high prevalence of multidrug resistance among the uropathogens highlights the need for surveillance of antimicrobial resistance among these pathogens.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

<p>Community acquired urinary tract infections among adults in Accra, Ghana</p>

Donkor¹,

Horlortu²,

Dayie³

et al. 2019

IDR

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“…One hundred and ten (43.8%) of the women with basic education had UTI and 45.5% were infected with E. coli . Forty-five percent of the pregnant women with secondary education had UTI and E. coli was associated with 52.2% [23]. The differences in rate of UTI in relation to educational status was statistically non-significant (p = 0.262).…”

Section: Resultsmentioning

confidence: 99%

Escherichia coli bacteriuria in pregnant women in Ghana: antibiotic resistance patterns and virulence factors

et al. 2018

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ObjectivesThe relevance of Escherichia coli associated bacteriuria infection in pregnant women is poorly understood, despite these strains sharing a similar virulence profile with other pathogenic E. coli causing severe obstetric and neonatal infections. We characterized and determined the antimicrobial susceptibility, resistance genes and virulence profiles of 82 E. coli isolates associated with asymptomatic bacteriuria in some pregnant in Ghana from February to August 2016 using Kirby–Bauer disc diffusion and polymerase chain reaction.ResultsHigh levels of antimicrobial resistance were observed to ampicillin (79.3%), tetracycline (70.7%) and cotrimoxazole (59.8%), except for cefuroxime (32.9%). Resistance genes analyses revealed 58.5% were positive for BlaTEM and 7.3% for aph(3)-Ia(aphA2). Virulence factors (VFs) was more widespread in pregnant women in the 2nd and 3rd trimesters than 1st trimester. VFs relating to adhesion (papC and iha), Protectins (traT), aerobactin acquisition (iutA) and iron acquisition systems (fyuA and irp2) were more prevalent in the resistant E. coli isolates. This study provides evidence for a link in bacteriuria and transmission of extra-intestinal E. coli in pregnant women to cause multi-resistant obstetric or neonatal infections. Considering the involvement of extra-intestinal E. coli in infections, results are helpful to develop strategies to prevent maternal and/ neonatal infections.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3989-y) contains supplementary material, which is available to authorized users.

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“… 24 , 25 Asymptomatic bacteriuria is known in SCD patients in Ghana, compared with their healthy counterparts. 26 Several reports indicate that high WBC counts usually observed in SCD population are mainly due to bacterial infections. 8 , 9 , 27 – 29 The current study, however, did not establish a relationship between bacterial infections and WBC counts among the SCD patients.…”

Section: Discussionmentioning

confidence: 99%

Hematological parameters in Ghanaian sickle cell disease patients

Antwi‐Boasiako¹,

Ekem²,

Abdul-Rahman³

et al. 2018

JBM

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BackgroundEffective treatment and management of sickle cell disease (SCD) has been a challenge in Africa over the years. Hematological parameters are very useful profiles in the effective management of the disease. However, there is scarcity of studies on the hematological parameters of SCD in Ghana. This study aimed at determining hematological parameters among SCD patients with vaso-occlusion, those in the steady state as well as healthy controls at a teaching hospital in Ghana.MethodologyThis was a cross-sectional study involving a total of 628 subjects, including 148 HbAA controls, 208 HbSS patients in steady state, 82 HbSC patients in steady state, 156 HbSS patients in vaso-occlusive crises (VOC), and 34 HbSC patients in VOC. Venous blood sample was collected from all study participants. A full blood count was done within 2 hours of collection, and hemoglobin (Hb) concentration, packed cell volume, red blood cell (RBC) concentration, mean corpuscular Hb, mean cell volume, mean corpuscular Hb concentration, and white blood cells (WBC) and platelet (PLT) counts were recorded.ResultsWBC and PLT counts were significantly higher in both female and male patients with SCD, compared with their healthy counterparts (P<0.05). The level of WBC was, however, significantly higher in patients with HbSS VOC among the SCD patients (P<0.001). Levels of Hb, RBC, and hematocrit were significantly higher in the controls (P<0.001). There was no significant difference in mean cell Hb among male patients with SCD (P=0.274) and female patients with SCD (P=0.5410).ConclusionThe SCD patients had lower Hb and RBC than the controls; however, higher PLT and WBC are noted in various status of SCD, possibly reflecting spleen effect in these patients. Further studies are needed to confirm these findings.

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Risk of Asymptomatic Bacteriuria among People with Sickle Cell Disease in Accra, Ghana

Cited by 11 publications

References 29 publications

<p>Community acquired urinary tract infections among adults in Accra, Ghana</p>

<p>Community acquired urinary tract infections among adults in Accra, Ghana</p>

Escherichia coli bacteriuria in pregnant women in Ghana: antibiotic resistance patterns and virulence factors

Hematological parameters in Ghanaian sickle cell disease patients

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