Alarming Levels of Multidrug Resistance in Aerobic Gram-Negative Bacilli Isolated from the Nasopharynx of Healthy Under-Five Children in Accra, Ghana

Mary-Magdalene Osei (), Nicholas T. K. D. Dayie, Godfred S. K. Azaglo, Elizabeth Y. Tettey, Edmund T. Nartey, Ama Fenny, Marcel Manzi, Ajay M. V. Kumar, Appiah-Korang Labi, Japheth A. Opintan and Eric Sampane-Donkor
Additional contact information
Mary-Magdalene Osei: Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
Nicholas T. K. D. Dayie: Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
Godfred S. K. Azaglo: Environmental Protection Agency, Starlet 91 Road, Ministries, Accra P.O. Box MB 326, Ghana
Elizabeth Y. Tettey: Korle-Bu Teaching Hospital, Guggisberg Avenue, Accra P.O. Box 77, Ghana
Edmund T. Nartey: Centre for Tropical Clinical Pharmacology & Therapeutics, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
Marcel Manzi: Department of Medical OCB, MSF-Belgium Headquarters, Rue de Bomel 65, 5000 Namur, Belgium
Ajay M. V. Kumar: International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France
Appiah-Korang Labi: World Health Organization Country Office, Roman Ridge, Accra P.O. Box MB 142, Ghana
Japheth A. Opintan: Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
Eric Sampane-Donkor: Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana

IJERPH, 2022, vol. 19, issue 17, 1-9

Abstract: Nasopharyngeal carriage of aerobic Gram-negative bacilli (GNB) may precede the development of invasive respiratory infections. We assessed the prevalence of nasopharyngeal carriage of aerobic GNB and their antimicrobial resistance patterns among healthy under-five children attending seven selected day-care centres in the Accra metropolis of the Greater Accra region of Ghana from September to December 2016. This cross-sectional study analysed a total of 410 frozen nasopharyngeal samples for GNB and antimicrobial drug resistance. The GNB prevalence was 13.9% (95% CI: 10.8–17.6%). The most common GNB were Escherichia coli (26.3%), Klebsiella pneumoniae (24.6%), and Enterobacter cloacae (17.5%). Resistance was most frequent for cefuroxime (73.7%), ampicillin (64.9%), and amoxicillin/clavulanic acid (59.6%). The organisms were least resistant to gentamicin (7.0%), amikacin (8.8%), and meropenem (8.8%). Multidrug resistance (MDR, being resistant to ≥3 classes of antibiotics) was observed in 66.7% (95% CI: 53.3–77.8%). Extended-spectrum beta-lactamase (ESBL)-producing bacteria constituted 17.5% (95% CI: 9.5–29.9%), AmpC-producing bacteria constituted 42.1% (95% CI: 29.8–55.5%), and carbapenemase-producing bacteria constituted 10.5% (95% CI: 4.7–21.8%) of isolates. The high levels of MDR are of great concern. These findings are useful in informing the choice of antibiotics in empiric treatment of GNB infections and call for improved infection control in day-care centres to prevent further transmission.

Keywords: Gram-negative bacilli (GNB); resistant pathogenic bacteria; nasopharyngeal carriage prevalence; extended-spectrum beta-lactamases (ESBL); AmpC; carbapenemase; Structured Operational Research and Training Initiative (SORT IT); operational research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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