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

Abstract 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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Molecular Characterization of Staphylococcus aureus Isolated from Chronic Infected Wounds in Rural Ghana

Microorganisms ◽

10.3390/microorganisms8122052 ◽

2020 ◽

Vol 8 (12) ◽

pp. 2052

Author(s):

Manuel Wolters ◽

Hagen Frickmann ◽

Martin Christner ◽

Anna Both ◽

Holger Rohde ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Population Structure ◽

Chronic Wounds ◽

Sequence Type ◽

Mechanisms Of Resistance ◽

Chloramphenicol Resistance ◽

Methicillin Resistant ◽

Rural Ghana ◽

Wide Range ◽

Infected Wounds

Background: Globally, Staphylococcus aureus is an important bacterial pathogen causing a wide range of community and hospital acquired infections. In Ghana, resistance of S. aureus to locally available antibiotics is increasing but the molecular basis of resistance and the population structure of S. aureus in particular in chronic wounds are poorly described. However, this information is essential to understand the underlying mechanisms of resistance and spread of resistant clones. We therefore subjected 28 S. aureus isolates from chronic infected wounds in a rural area of Ghana to whole genome sequencing. Results: Overall, resistance of S. aureus to locally available antibiotics was high and 29% were Methicillin resistant Staphylococcus aureus (MRSA). The most abundant sequence type was ST88 (29%, 8/28) followed by ST152 (18%, 5/28). All ST88 carried the mecA gene, which was associated with this sequence type only. Chloramphenicol resistance gene fexB was exclusively associated with the methicillin-resistant ST88 strains. Panton-Valentine leukocidin (PVL) carriage was associated with ST121 and ST152. Other detected mechanisms of resistance included dfrG, conferring resistance to trimethoprim. Conclusions: This study provides valuable information for understanding the population structure and resistance mechanisms of S. aureus isolated from chronic wound infections in rural Ghana.

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Bacterial profile and antimicrobial susceptibility patterns of otitis media among children in Qatar

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193655 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3311

Author(s):

Qasem Buhaibeh ◽

Tawfik Dhaiban ◽

Eiman Alyafei ◽

Amjad Salman Al-Jundi Abdulsalam

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Antimicrobial Resistance ◽

Otitis Media ◽

Antimicrobial Susceptibility ◽

Harmful Effect ◽

Resistance Pattern ◽

Resistant Bacteria ◽

Klebsiella Pneumonia ◽

Susceptibility Patterns

Background: Otitis Media (OM) common diseases affecting children below 5 years of age with a harmful effect on their hearing and health status. Data about the bacterial profile and current antimicrobial resistance status of Otitis Media in the region is scarce. Objective of this study determine the causative organisms of Otitis Media and antimicrobial susceptibility patterns among children in a Primary Health Care Corporation (PPHC) centers, Qatar.Methods: A cross-sectional study was conducted in PPHC from Jan 2016 to Dec 2017. A total of 181 patients with Otitis Media presented to PHCC centers were enrolled in the study. Socio-demographic and clinical data were documented and analysed.Results: A total of 181 children, an almost equal number of male (49.7%) and female (50.3%) participants were involved in the study. 51.4% of participants were ≤5 years of age. Bacteria isolated were: Pseudomonas Aeruginosa (27.6%), Hemophilus Influenza (13.3%), Staphylococcus Aureus (11.6%), Methicillin-Resistant Staphylococcus Aureus (MSRA) (11.0%), Streptococcus Pyogenes (10.5%), Streptococcus Pneumonia (6.6%), Moraxella Catarrhalis (2.2%), Klebsiella Pneumonia (0.6%). The sensitivity of Pseudomonas Aeruginosa was (100%) to cotrimoxazole, vancomycin, and piperacillin, (96%) to cefepime and gentamicin, and was (88.2%) to ciprofloxacin. MRSA sensitivity was (100%) to vancomycin, rifampicin, and teicoplanin, (89%) to clindamycin.Conclusion: Pseudomonas Aeruginosa was the most frequent isolated bacteria. An overall antimicrobial resistance pattern seen in bacteria isolates ranges from 0% to 66.7%. The antimicrobial-resistant rate was observed for Ampicillin, Augmentin, and cefuroxime whereas ciprofloxacin, cefepime, chloramphenicol, cotrimoxazole, gentamicin, vancomycin, and amikacin were found effective for the isolated resistant bacteria.

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Clinical Relevance of the Antimicrobial Resistance Testing in the Treatment of Chronic Wounds With Antiseptics

Case Medical Research ◽

10.31525/ct1-nct04172363 ◽

2019 ◽

Author(s):

Keyword(s):

Antimicrobial Resistance ◽

Clinical Relevance ◽

Chronic Wounds ◽

Resistance Testing

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The Role of Aquatic Ecosystems (River Tua, Portugal) as Reservoirs of Multidrug-Resistant Aeromonas spp.

Water ◽

10.3390/w13050698 ◽

2021 ◽

Vol 13 (5) ◽

pp. 698

Author(s):

Sónia Gomes ◽

Conceição Fernandes ◽

Sandra Monteiro ◽

Edna Cabecinha ◽

Amílcar Teixeira ◽

...

Keyword(s):

Antibiotic Resistance ◽

Antimicrobial Resistance ◽

Nalidixic Acid ◽

Water Samples ◽

Aquatic Ecosystems ◽

Anthropogenic Activities ◽

Aquatic Organisms ◽

Resistant Bacteria ◽

Anthropogenic Pressures ◽

Resistance Rates

The inappropriate use of antibiotics, one of the causes of the high incidence of antimicrobial-resistant bacteria isolated from aquatic ecosystems, represents a risk for aquatic organisms and the welfare of humans. This study aimed to determine the antimicrobial resistance rates among riverine Aeromonas spp., taken as representative of the autochthonous microbiota, to evaluate the level of antibacterial resistance in the Tua River (Douro basin). The prevalence and degree of antibiotic resistance was examined using motile aeromonads as a potential indicator of antimicrobial susceptibility for the aquatic environment. Water samples were collected from the middle sector of the river, which is most impacted area by several anthropogenic pressures. Water samples were plated on an Aeromonas-selective agar, with and without antibiotics. The activity of 19 antibiotics was studied against 30 isolates of Aeromonas spp. using the standard agar dilution susceptibility test. Antibiotic resistance rates were fosfomycin (FOS) 83.33%, nalidixic acid (NA) 60%, cefotaxime (CTX) 40%, gentamicin (CN) 26.67%, tobramycin (TOB) 26.67%, cotrimoxazole (SXT) 26.67%, chloramphenicol (C) 16.67%, and tetracycline (TE) 13.33%. Some of the nalidixic acid-resistant strains were susceptible to fluoroquinolones. Multiple resistance was also observed (83.33%). The environmental ubiquity, the natural susceptibility to antimicrobials and the zoonotic potential of Aeromonas spp. make them optimal candidates for studying antimicrobial resistance (AMR) in aquatic ecosystems. Aquatic environments may provide an ideal setting for the acquisition and dissemination of antibiotic resistance because anthropogenic activities frequently impact them. The potential risk of multi- and pan-resistant bacteria transmission between animals and humans should be considered in a “One Health—One World” concept.

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ESBL Activity, MDR, and Carbapenem Resistance among Predominant Enterobacterales Isolated in 2019

Antibiotics ◽

10.3390/antibiotics10060744 ◽

2021 ◽

Vol 10 (6) ◽

pp. 744

Author(s):

Altaf Bandy ◽

Bilal Tantry

Keyword(s):

Escherichia Coli ◽

Saudi Arabia ◽

Antimicrobial Resistance ◽

Carbapenem Resistance ◽

Resistant Bacteria ◽

Sociodemographic Characteristics ◽

Chi Square ◽

E Coli ◽

Chi Square Test ◽

Resistance Rates

Antimicrobial-resistance in Enterobacterales is a serious concern in Saudi Arabia. The present study retrospectively analyzed the antibiograms of Enterobacterales identified from 1 January 2019 to 31 December 2019 from a referral hospital in the Aljouf region of Saudi Arabia. The revised document of the Centers for Disease Control (CDC) CR-2015 and Magiorakos et al.’s document were used to define carbapenem resistance and classify resistant bacteria, respectively. The association of carbapenem resistance, MDR, and ESBL with various sociodemographic characteristics was assessed by the chi-square test and odds ratios. In total, 617 Enterobacterales were identified. The predominant (n = 533 (86.4%)) isolates consisted of 232 (37.6%), 200 (32.4%), and 101 (16.4%) Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis, respectively. In general, 432 (81.0%) and 128 (24.0%) isolates were of MDR and ESBL, respectively. The MDR strains were recovered in higher frequency from intensive care units (OR = 3.24 (1.78–5.91); p < 0.01). E. coli and K. pneumoniae resistance rates to imipenem (2.55 (1.21–5.37); p < 0.01) and meropenem (2.18 (1.01–4.67); p < 0.04), respectively, were significantly higher in winter. The data emphasize that MDR isolates among Enterobacterales are highly prevalent. The studied Enterobacterales exhibited seasonal variation in antimicrobial resistance rates towards carbapenems and ESBL activity.

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EPISIOTOMY INFECTIONS IN THE PUERPERIUM AND ANTIMICROBIAL RESISTANCE OF RESPONSIBLE PATHOGENS IN UKRAINE

Wiadomości Lekarskie ◽

10.36740/wlek202011101 ◽

2020 ◽

Vol 73 (11) ◽

pp. 2325-2331

Author(s):

Aidyn G. Salmanov ◽

Taras G. Voitok ◽

Igor V. Maidannyk ◽

Serhiy Yu. Vdovychenko ◽

Olena О. Chorna ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Resistance ◽

Vaginal Delivery ◽

Prevalence Rate ◽

Methicillin Resistance ◽

Carbapenem Resistance ◽

Resistant Bacteria ◽

Esbl Production ◽

Multicenter Cohort Study ◽

Klebsiella Spp

1 2 ABSTRACT The aim: To obtain the first estimates of the current prevalence rate of episiotomy infections in the puerperium and antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data. The study population consisted of all women who had a vaginal delivery in 7 Regional Women’s Hospitals of Ukraine. Definitions of episiotomy infections were used from the Centers for Disease Control and Prevention’s National Healthcare Safety Network (CDC/NHSN). Results: Total 35.6% women after vaginal delivery had episiotomy done. The prevalence rate of episiotomy infections was 17.7%. The predominant pathogens were: Escherichia coli (49.2%), Enterobacter spp. (11.1%), Streptococcus spp. (9.1%), Enterococcus faecalis (6.5%), Klebsiella spp. (8.1%), followed by Pseudomonas aeruginosa (4.7%), Staphylococcus aureus (4.2%), Proteus spp.(2.9%) and Staphylococcus epidermidis (2.8%). The overall proportion of methicillin-resistance was observed in 17.3% of Staphylococcus aureus (MRSA). Vancomycin resistance was observed in 6.8% of isolated enterococci. Carbapenem resistance was identified in 8% of P.aeruginosa isolates. Resistance to third-generation cephalosporins was observed in 15.2% Klebsiella spp. and E.coli 16.4% isolates. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 26.4%. The prevalence of ESBL production among E. coli isolates was significantly higher than in K. pneumoniae (31.4%, vs 12.5%). Conclusions: Episiotomy infections in the puerperium are common in Ukraine and most of these infections caused by antibiotic-resistant bacteria. Optimizing the management and empirical antimicrobial therapy may reduce the burden of episiotomy infections, but prevention is the key element.

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CON: COVID-19 will not result in increased antimicrobial resistance prevalence

JAC-Antimicrobial Resistance ◽

10.1093/jacamr/dlaa051 ◽

2020 ◽

Vol 2 (3) ◽

Cited By ~ 3

Author(s):

Peter Collignon ◽

John J Beggs

Keyword(s):

Antimicrobial Resistance ◽

Infection Prevention ◽

Developed Countries ◽

International Travel ◽

Infection Prevention And Control ◽

Resistant Bacteria ◽

Healthcare Facilities ◽

Factors Associated ◽

Resistance Rates ◽

And Control

Abstract Antimicrobial resistance (AMR) is affected by many factors, but too much of our focus has been on antimicrobial usage. The major factor that drives resistance rates globally is spread. The COVID-19 pandemic should lead to improved infection prevention and control practices, both in healthcare facilities and the community. COVID-19 will also have ongoing and profound effects on local, national and international travel. All these factors should lead to a decrease in the spread of resistant bacteria. So overall, COVID-19 should lead to a fall in resistance rates seen in many countries. For this debate we show why, overall, COVID-19 will not result in increased AMR prevalence. But globally, changes in AMR rates will not be uniform. In wealthier and developed countries, resistance rates will likely decrease, but in many other countries there are already too many factors associated with poor controls on the spread of bacteria and viruses (e.g. poor water and sanitation, poor public health, corrupt government, inadequate housing, etc.). In these countries, if economies and governance deteriorate further, we might see even more transmission of resistant bacteria.

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High Prevalence of Antimicrobial Resistance Among Gram-Negative Isolated Bacilli in Intensive Care Units at a Tertiary-Care Hospital in Yucatán Mexico

Medicina ◽

10.3390/medicina55090588 ◽

2019 ◽

Vol 55 (9) ◽

pp. 588 ◽

Cited By ~ 2

Author(s):

Andrés H. Uc-Cachón ◽

Carlos Gracida-Osorno ◽

Iván G. Luna-Chi ◽

Jonathan G. Jiménez-Guillermo ◽

Gloria M. Molina-Salinas

Keyword(s):

Escherichia Coli ◽

Intensive Care ◽

Antimicrobial Resistance ◽

Intensive Care Units ◽

High Resistance ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Gram Negative ◽

Resistance Rates

Background and Objectives: Antimicrobial resistance (AMR) is increasing worldwide and imposes significant life-threatening risks to several different populations, especially to those in intensive care units (ICU). The most commonly isolated organisms in ICU comprise gram-negative bacilli (GNB), and these represent a leading cause of serious infections. This study was conducted to describe the prevalence of resistance in GNB isolated from patients in adults, pediatric, and neonatal ICU in a tertiary-care hospital in Mérida, Mexico. Materials and Methods: A retrospective study was done on samples collected in Neonatal (NICU), Pediatric (PICU) and Adult (AICU) ICU of Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social in Mérida, México. The identification of isolates and antimicrobial susceptibility testing were performed using an automated system. Results: A total of 517 GNB strains were isolated. The most common positive culture was bronchial secretions. Pseudomonas aeruginosa was the prevalent pathogen in NICU and PICU, whereas Escherichia coli was common in the AICU. Overall, GNB exhibited a high resistance rates for Ampicillin (95.85%), Cefuroxime (84.17%), Piperacillin (82.93%), Cefotaxime (78.07%), Ceftriaxone (77.41%), Aztreonam (75.23%), Cefazolin (75.00%), and Ceftazidime (73.19%). There are significant differences in the resistance rates of GNB from different ICUs for penicillins, cephalosporins, carbapenems and fluoroquinolones drugs. Escherichia coli (multidrug-resistant [MDR] = 91.57%, highly resistant microorganisms [HRMO] = 90.36%) and Acinetobacter baumannii (MDR = 86.79%, HRMO = 83.02%) exhibited the highest percentage of MDR and HRMO profiles. The prevalence of the extended-spectrum beta-lactamases (ESBL)-producing isolates was 83.13% in E. coli, 78.84% in Klebsiella pneumoniae, and 66.67% in Proteus mirabilis, respectively. Conclusions: The high resistance rates to drugs were exhibited by our GNB isolates. Continuous surveillance and control of the use of antimicrobials are urgently needed to reduce the emergence and spreading of MDR, HRMO, and/or ESBL-producing bacilli.

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Prevalence and antimicrobial resistance of Salmonella serotypes isolated from retail chicken meat and giblets in Iran

The Journal of Infection in Developing Countries ◽

10.3855/jidc.5945 ◽

2015 ◽

Vol 9 (05) ◽

pp. 463-469 ◽

Cited By ~ 19

Author(s):

Hamid Reza Sodagari ◽

Zohreh Mashak ◽

Amir Ghadimianazar

Keyword(s):

Antimicrobial Resistance ◽

Foodborne Pathogens ◽

Chicken Meat ◽

Resistance Testing ◽

Retail Markets ◽

Predominant Type ◽

Amoxicillin Clavulanic Acid ◽

Resistant Strains ◽

Resistance Rates ◽

Retail Chicken Meat

Introduction: Salmonella is one of the major foodborne pathogens responsible for outbreaks of foodborne illness in humans worldwide. Methodology: A total of 560 samples of chicken meat and giblets were collected from retail markets for Salmonella identification, serotyping, and antimicrobial resistance testing. Results: Salmonella was detected in 19.8% of samples. Among the five serotypes identified, S. Thompson was the predominant type (48.7%). High antimicrobial resistance rates were observed to nalidixic acid (92.8%), tetracycline (81%), trimethoprim (68.4%), sulfamethoxazole / trimethoprim (61.2%), streptomycin (56.7%), and kanamycin (36.9%). Although resistance to chloramphenicol (3.6%), amoxicillin-clavulanic acid (5.4%), and ampicillin (11.7%) was detected, none of the isolates were resistant to ceftazidime, ceftriaxone, cefotaxime, ciprofloxacin, colistin, gentamicin, nor imipenem. Conclusions: Restrictions on the irrational use of antibiotics in humans and animals are suggested for the reduction of resistant strains.

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