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

Krumkamp, Ralf; Oppong, Kwabena; Hogan, Benedikt; Strauss, Ricardo; Frickmann, Hagen; Wiafe-Akenten, Charity; Boahen, Kennedy Gyau; Rickerts, Volker; McCormick, Ilka; Groß, Uwe; Schulze, Marco H.; Jaeger, Anna; Loderstädt, Ulrike; Sarpong, Nimako; Owusu‐Dabo, Ellis; May, Jürgen; Dekker, Denise

doi:10.21203/rs.3.rs-16528/v1

Cited by 10 publications

(1 citation statement)

References 27 publications

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“…В микробных ассоциациях, выделяемых из ран, присутствуют золотистый стафилококк (35%), КОС, энтеробактерии [2]. В процессе нахождения в стационаре происходит смена грампозитивной флоры на грамнегативную, удельный вес которой может достигать 70% [2,13].…”

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The monitoring of the resistance of gram-negative microfl ora, isolated in the patients with purulent wounds

Fedzianin¹,

Okulich²

2020

Vestnik VSMU

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Цель исследования – изучить динамику резистентности грамотрицательной флоры к антибактериальным лекарственным средствам у пациентов с гнойными ранами. Материал и методы. На базе бактериологической лаборатории в 2006-2007 и в 2019-2020 годах обследованы бактериологическими методами 92 и 99 пациентов с гнойными ранами различных локализаций, соответственно. Пациенты проходили стационарное лечение в отделении гнойной хирургии УЗ «Витебская областная клиническая больница». Определение видовой принадлежности микроорганизмов производилось в автоматическом режиме на биохимическом анализаторе АТВ Expression bioMerieux с использованием тест-систем: ID 32 E – для энтеробактерий, ID 32 GN – для грамотрицательных палочек (Франция) и разработанных нами тест-систем ИД-ЭНТ для энтеробактерий (БелВитунифарм). Определение резистентности микроорганизмов производилось в автоматическом режиме на биохимическом анализаторе АТВ Expression bioMerieux с использованием тест-систем: АTB PSE – для псевдомонад, rapid ATB E – для энтеробактерий (Франция) и разработанных нами тест-систем АБ-ПСЕВ, АБ-ЭНТЕР, АБ-ГРАМ- для псевдомонад, энтеробактерий и грамотрицательной флоры (БелВитунифарм). Результаты. В результате проведенных исследований установлено, что на 12,25% (р<0,05) увеличилась доля K.pneumoniae в этиологической структуре гнойных ран, на 14,69% (р<0,05) – A.baumannii. За время мониторинга значительно увеличилась резистентность грамотрицательной флоры практически ко всем исследуемым антибактериальным лекарственным средствам. Высокую противомикробную активность сохранили только колистин и тигециклин. Заключение. За 13 лет произошли существенные изменения в этиологической структуре грамотрицательных микроорганизмов, выделенных у пациентов с гнойными ранами. Отмечается достоверное увеличение доли грамотрицательных проблемных возбудителей, таких как K.pneumoniae и A.baumannii, в этиологической структуре гнойных ран. За время мониторинга значительно увеличилась резистентность грамотрицательной флоры практически ко всем антибактериальным лекарственным средствам. Полученные результаты необходимо учитывать при проведении антибиотикотерапии у пациентов с гнойными ранами.

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The monitoring of the resistance of gram-negative microfl ora, isolated in the patients with purulent wounds

Fedzianin¹,

Okulich²

2020

Vestnik VSMU

View full text Add to dashboard Cite

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Clonal Clusters, Molecular Resistance Mechanisms and Virulence Factors of Gram-Negative Bacteria Isolated from Chronic Wounds in Ghana

et al. 2021

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Wound infections are common medical problems in sub-Saharan Africa but data on the molecular epidemiology are rare. Within this study we assessed the clonal lineages, resistance genes and virulence factors of Gram-negative bacteria isolated from Ghanaian patients with chronic wounds. From a previous study, 49 Pseudomonas aeruginosa, 21 Klebsiella pneumoniae complex members and 12 Escherichia coli were subjected to whole genome sequencing. Sequence analysis indicated high clonal diversity with only nine P. aeruginosa clusters comprising two strains each and one E. coli cluster comprising three strains with high phylogenetic relationship suggesting nosocomial transmission. Acquired beta-lactamase genes were observed in some isolates next to a broad spectrum of additional genetic resistance determinants. Phenotypical expression of extended-spectrum beta-lactamase activity in the Enterobacterales was associated with blaCTX-M-15 genes, which are frequent in Ghana. Frequently recorded virulence genes comprised genes related to invasion and iron-uptake in E. coli, genes related to adherence, iron-uptake, secretion systems and antiphagocytosis in P. aeruginosa and genes related to adherence, biofilm formation, immune evasion, iron-uptake and secretion systems in K. pneumonia complex. In summary, the study provides a piece in the puzzle of the molecular epidemiology of Gram-negative bacteria in chronic wounds in rural Ghana.

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Microbial Species Isolated from Infected Wounds and Antimicrobial Resistance Analysis: Data Emerging from a Three-Years Retrospective Study

et al. 2021

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The antimicrobial resistance is a topic of global interest in the treatment of wound infections. The goal of this retrospective study was both the identification of the microorganisms responsible for wound infections and the determination of their drug susceptibility pattern. The study was performed from 2017 to 2019 and included 239 patients. Thirty-four species were isolated by culture methods and identified and analysed for their susceptibility patterns to antimicrobials through the Walk Away automated system. The presence of one species was the most frequent condition (75.3%), whereas a co-infection was detected in 24.7% of samples. The most common species were Gram-negative (57.9%), amongst which the most prevalent were Pseudomonas aeruginosa (40.2%), Escherichia coli (20.7%), Proteus mirabilis (11.2%), and Acinetobacter baumannii/haemolyticus (9.5%). Gram-positive bacteria were observed in 36.6%, Staphylococcus aureus (79.4%) being the most predominant species. At least one resistance to antibiotics was detected in 88.2% of isolates, while a multi-drug-resistance versus no less than 6 antimicrobials was detected in 29.2% of isolates. Although multi-drug resistant species and co-infections were observed, those were less frequently observed at the wound site. These conditions make the microorganisms eradication more difficult. The detection of a polymicrobial infection and multi-drug resistant microorganisms followed by a proper therapeutic treatment would lead to the resolution of the infection, promoting wound healing and the limitation of the spread of antibiotic resistance.

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

Cited by 10 publications

References 27 publications

The monitoring of the resistance of gram-negative microfl ora, isolated in the patients with purulent wounds

The monitoring of the resistance of gram-negative microfl ora, isolated in the patients with purulent wounds

Clonal Clusters, Molecular Resistance Mechanisms and Virulence Factors of Gram-Negative Bacteria Isolated from Chronic Wounds in Ghana

Microbial Species Isolated from Infected Wounds and Antimicrobial Resistance Analysis: Data Emerging from a Three-Years Retrospective Study

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