Diversity and antibiograms of bacteria isolated from cutaneous leishmaniasis wounds in the Nkwanta South District of Ghana.

Leishmaniasis is a vector-borne disease caused by an intracellular protozoan parasite. The presence of secondary bacterial infections in cutaneous leishmaniasis wounds exacerbate lesion development and could lead to delay in the healing process. This study sought to determine the resistance patterns of bacteria co-infecting cutaneous leishmaniasis wounds from selected communities in the Nkwanta district. Various bacteria were isolated and characterized from exudates obtained from wound swabs collected with sterile cotton tipped applicators. Confirmation of bacterial identity was done using the analytical profile index and the matrix-assisted laser desorption/ionization time of flight mass spectrometry. Antibiotic susceptibility tests were performed using agar disc diffusion method according to the Clinical and Laboratory Standards Institute breakpoint values. A total of eleven (11) secondary bacterial species (spp) were isolated from the 33 wound samples that tested positive for Leishmania kinetoplast DNA, among which Staphylococcus aureus was the most predominant (31%). The pathogenic bacteria that colonized the wounds included Bacillus subtilis (23.8%), Pantoea species (11.9%), Klebsiella pneumoniea (7.1%), Enterobacter cloacae (7.1%), Aeromonas species (4.8%), Serratia marcescens (4.8%), Serratia liquefacien (2.4%), Serratia plymutheca (2.4%), Providencia rettgeri (2.4%) and Cronobacter species (2.4%). Most of the isolates were resistant to beta-lactam antibiotics and the third-generation cephalosporin. Notably, 84.6% of the S. aureus isolates were methicillin and ciprofloxacin resistant whilst 92.3% were resistant to ampicillin. About sixty-nine percent (69.2%) showed intermediate susceptibility to Erythromycin. Additionally, S. plymutheca was resistant to all the test antibiotics. This study suggests colonization of cutaneous leishmaniasis wounds with varied bacterial species that are mostly resistant to beta-lactam group of antibiotics.

Development of a local antibiogram for a teaching hospital in Ghana.

Background: Antimicrobial resistance threatens adequate healthcare provision against infectious diseases. Antibiograms, combined with patient clinical history, enable clinicians and pharmacists to select the best empirical treatments prior to culture results. Objectives: To develop a local antibiogram for the Ho Teaching Hospital. Methods: This was a retrospective cross-sectional study, using data collected on bacterial isolates from January-December 2021. Samples from urine, stool, sputum, blood, and cerebrospinal fluid (CSF) were considered as well as, aspirates and swabs from wound, ears and vagina of patients. Bacteria were cultured on both enrichment and selective media including blood agar supplemented with 5% sheep blood and MacConkey agar, and identified by both the VITEK 2 system and routine biochemical tests. Data on routine culture and sensitivity tests performed on bacterial isolates from patient samples were retrieved from the hospital's health information system. Data were then entered into and analysed using WHONET. Results: In all, 891 pathogenic microorganisms were isolated from 835 patients who had positive culture tests. Gram-negative isolates accounted for about 77% of the total bacterial species. Escherichia coli (246), Pseudomonas spp. (180), Klebsiella spp. (168), Citrobacter spp. (101) and Staphylococcus spp. (78) were the five most isolated pathogens. Most of the bacterial isolates showed high resistance (>70%) to ampicillin, piperacillin, ceftazidime, ceftriaxone, cefotaxime, penicillin G, amoxicillin, amoxicillin/clavulanic acid, ticarcillin/clavulanic acid and trimethoprim/sulfamethoxazole. Conclusions: The isolates from the various samples were not susceptible to most of the antibiotics used in the study. The study reveals the resistance patterns of E. coli and Klebsiella spp. to some antibiotics on the WHO 'Watch' and 'Reserve' lists. Using antibiograms as part of antimicrobial stewardship programmes would optimize antibiotic use and preserve their efficacy.

Sensitivity Patterns, Plasmid Profiles and Clonal Relatedness of Multi-Drug Resistant Pseudomonas aeruginosa Isolated From the Ashanti Region, Ghana.

Pseudomonas aeruginosa is a major cause of most opportunistic nosocomial infections in Ghana. The study sought to characterize P. aeruginosa isolates from market environments, poultry farms and clinical samples of patients from 2 district hospitals in the Ashanti region of Ghana. The genetic relatedness, plasmid profiles and antimicrobial sensitivity of the isolates were investigated. Culture based isolation and oprL gene amplification were used to confirm the identity of the isolates. Susceptibility testing was conducted using the Kirby Bauer disk diffusion method. Random whole genome typing of the P. aeruginosa strains was done using Enterobacterial repetitive-intergenic consensus based (ERIC) PCR assay. The most active agents against P. aeruginosa isolates were ceftazidime (90%), piperacillin (85%), meropenem, cefipeme and ticarcillin/clavulanic acid (81.6%). The isolates were most resistant to gentamycin (69%), ciprofloxacin (62.1%), ticarcillin (56.3%) and aztreonam (25%). About 65% (n = 38) of the multi-drug resistant (MDR) P. aeruginosa isolates harbored 1 to 5 plasmids with sizes ranging from 2 to 116.8 kb. A total of 27 clonal patterns were identified. Two major clones were observed with a clone showing resistance to all the test antipseudomonal agents. There is therefore a need for continued intensive surveillance to control the spread and development of resistant strains.

Prevalence and Phenotypic and Genotypic Resistance Mechanisms of Multidrug-Resistant Pseudomonas aeruginosa Strains Isolated from Clinical, Environmental, and Poultry Litter Samples from the Ashanti Region of Ghana.

Background: Antibiotic resistance in bacteria is a major global health challenge. Reports on the prevalence of multidrug-resistant P. aeruginosa, a common pathogenic bacterium implicated in nosocomial infections and poultry diseases, are limited in Ghana. This study therefore sought to determine the prevalence of P. aeruginosa from hospitals, poultry farms, and environmental samples from the Ashanti region of Ghana. Methodology. Stool, urine, and blood samples from 364 patients from two hospitals in the Ashanti region of Ghana were randomly sampled. P. aeruginosa was isolated and confirmed using routine selective media and PCR-based oprL gene amplification. The Kirby-Bauer disk diffusion method employing EUCAST breakpoint values was used to identify multidrug-resistant strains. The occurrence of common antibiotic inactivating enzymes and resistance encoding genes and the assessment of strain efflux capacity were investigated with double disc synergy test (DDST), imipenem-EDTA synergy test, phenylboronic acid test, D-test, routine PCR, and ethidium bromide agar-cartwheel method. Results: A total of 87 (9.7%, n = 87/900) P. aeruginosa isolates were confirmed from the samples. 75% (n = 65/87) were resistant to more than one group of antipseudomonal agents, while 43.6% (n = 38/87) were multidrug-resistant (MDR). High prevalence of extended spectrum ß-lactamases (84.2%), metallo-ß-lactamases (34.1%), and AmpC inducible cephalosporinases (50%) was observed in the MDR strains. About 57.8% of the MDR strains showed moderate to very high efflux capacity. Class 1 integrons were detected in 89.4% of the MDR isolates but ß-lactamase encoding genes (bla SHV , bla TEM , bla CTX-M , bla VIM , and bla IMP ) were not detected. Conclusion: Surveillance of antibiotic-resistant strains of bacteria should be routinely conducted in clinical and veterinary practice in Ghana to inform selection of antibiotics for therapeutic use.

Prevalence and antibiotic resistance of coagulase-negative Staphylococci isolated from poultry farms in three regions of Ghana.

The use of antibiotics in animal production has been associated with the development and spread of antibiotic-resistant organisms including commensals. Coagulase-negative Staphylococcus (CoNS) species, which were until recently considered non-pathogenic, have been associated with opportunistic infections and high resistance to several antibiotics. This study sought to determine the prevalence, identity, and phenotypic resistance of coagulase-negative Staphylococcus spp. isolated from some selected poultry farms and farm workers in the Ashanti, Brong Ahafo, and Greater Accra regions of Ghana. Poultry litter samples and oral swabs of poultry farm workers were collected, from which bacterial species were isolated, identified, and analyzed. Various selective media were used for the presumptive identification of the different species. Confirmation of bacterial identity was done using matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry. Antibiotic susceptibility testing of the isolates was performed using the Kirby-Bauer disk diffusion method. Zones of growth inhibition were interpreted based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Two hundred and fifty-six coagulase-negative Staphylococcus spp., comprising S. sciuri (42.97%), S. lentus (35.94%), S. gallinarum (6.64%), S. xylosus (4.30%), S. haemolyticus (3.91%), S. saprophyticus (1.95%), and S. cohnii (0.39%) were confirmed by MALDI-TOF. CoNS were isolated from samples from the Brong Ahafo (48.83%), Ashanti (33.59%), and Greater Accra (17.78%) regions. Isolates from poultry litter constituted 55.47%, and farm workers 44.53%. All the isolates were susceptible to amoxicillin/clavulanic acid and amikacin. The isolates exhibited high resistance toward tetracycline (57.03%), doxycycline (43.75%), and oxacillin (43.36%). Multi-drug resistance (MDR) was observed in 19.14% of the isolates. MDR was higher in isolates obtained from poultry farm workers (61.22%) than isolates from poultry litter (38.78%). The above findings call for stricter monitoring of antibiotic usage in both animal production and in humans.