Diarrhea-Causing Bacteria and Their Antibiotic Resistance Patterns Among Diarrhea Patients From Ghana

Frontiers in Microbiology

Adwoa Asante-Poku¹  Abdul Basit Musah¹  Diana Asema Asandem¹  Abraham Kwabena Anang¹  Dorothy Yeboah-Manu¹  Prince Asare¹  Theophilus Afum¹  Gloria Ivy Mensah¹  Kwadwo Ansah Koram¹  Hiroshi Kiyono²  Thelma Aphour³  Franklin Asiedu-Bekoe³  Nuhu Muniru Guinko³  Doris Arhin³  David Opare³  Kiyosi Taniguchi⁴  Koichi Ishikawa⁵  Tetsuro Matano⁵  Taketoshi Mizutani⁶ 

[1] College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana;Department of Medicine, CU-UCSD Center for Mucosal Immunology, Allergy and Vaccines (cMAV), University of California San Diego, San Diego, CA, United States;Ghana Health Service, Accra, Ghana;Graduate School of Medicine, Institute for Global Prominent Research, Chiba University, Chiba, Japan;Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan;The Institute of Medical Science, The University of Tokyo, Tokyo, Japan;

关键词: diarrhea;    bacteria;    resistance;    antimicrobial;    susceptibility;   

DOI  :  10.3389/fmicb.2022.894319

来源: DOAJ

【 摘 要 】

Diarrheal disease remains a major global health problem particularly in children under 5 years and the emergence of antibiotic-resistant strains of causative pathogens could slow control efforts, particularly in settings where treatment options are limited. This surveillance study conducted in Ghana aimed to determine the prevalence and antimicrobial susceptibility profile of diarrhea-causing bacteria. This was a cross-sectional study carried out in five health facilities in the Ga West Municipality of Ghana between 2017 and 2021. Diarrheic stool samples from patients were collected and cultured on standard differential/selective media and isolates identified by standard biochemical tests, MALDI-TOF assay, and serological analysis. The antibiogram was determined using Kirby-Bauer disk diffusion and Microscan autoScan4 MIC panels which were used for extended-spectrum beta-lactamase (ESBL) detection. Bacteria were isolated from 97.5% (772/792) of stool samples, and 167 of the isolates were diarrheagenic and met our inclusion criteria for antimicrobial resistance (AMR) analysis. These included Escherichia coli (49.1%, 82/167), Salmonella species (23.9%, 40/167), Vibrio species (16.8%, 28/167), and Shigella species (10.2%, 17/167). Among 24 Vibrio species, we observed resistances to cefotaxime (21/24, 87.5%), ceftriaxone (20/24, 83.3%), and ciprofloxacin (6/24, 25%), including four multi-drug resistant isolates. All 13 Vibrio parahaemolyticus isolates were resistant to cefazolin. All 17 Shigella isolates were resistant to tetracycline with resistance to shigellosis drugs such as norfloxacin and ciprofloxacin. Salmonella isolates were highly susceptible to norfloxacin (40/40, 100%) and tetracycline (12/34, 35%). Two ESBL-producing E. coli were also identified with marked susceptibility to gentamicin (66/72, 91.7%) and amikacin (57/72, 79.2%) prescribed in the treatment of E. coli infections. This study showed the different bacteria implicated in diarrhea cases in Ghana and the need for differential diagnoses for better treatment outcomes. Escherichia coli, Shigella, Salmonella, and Vibrio have all been implicated in diarrhea cases in Ghana. The highest prevalence was E. coli and Salmonella with Shigella the least prevalent. Resistance to commonly used drugs found in these isolates may render bacteria infection treatment in the near future nearly impossible. Routine antimicrobial susceptibility testing, effective monitoring, and nationwide surveillance of AMR pathogens should be implemented to curb the increase of antimicrobial resistance in Ghana.

【 授权许可】

Unknown