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

• Published in: Frontiers in microbiology 2022-05, Vol.13, p.894319-894319
• Main Authors: Afum, Theophilus, Asandem, Diana Asema, Asare, Prince, Asante-Poku, Adwoa, Mensah, Gloria Ivy, Musah, Abdul Basit, Opare, David, Taniguchi, Kiyosi, Guinko, Nuhu Muniru, Aphour, Thelma, Arhin, Doris, Ishikawa, Koichi, Matano, Tetsuro, Mizutani, Taketoshi, Asiedu-Bekoe, Franklin, Kiyono, Hiroshi, Anang, Abraham Kwabena, Koram, Kwadwo Ansah, Yeboah-Manu, Dorothy
• Format: Article
• Language: English
• Subjects: antimicrobial; bacteria; diarrhea; Microbiology; resistance; susceptibility
• ISSN: 1664-302X; 1664-302X
• DOI: 10.3389/fmicb.2022.894319

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 (49.1%, 82/167), species (23.9%, 40/167), species (16.8%, 28/167), and species (10.2%, 17/167). Among 24 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 isolates were resistant to cefazolin. All 17 isolates were resistant to tetracycline with resistance to shigellosis drugs such as norfloxacin and ciprofloxacin. isolates were highly susceptible to norfloxacin (40/40, 100%) and tetracycline (12/34, 35%). Two ESBL-producing were also identified with marked susceptibility to gentamicin (66/72, 91.7%) and amikacin (57/72, 79.2%) prescribed in the treatment of infections. This study showed the different bacteria implicated in diarrhea cases in Ghana and the need for differential diagnoses for better treatment outcomes. , , , and have all been implicated in diarrhea cases in Ghana. The highest prevalence was and with 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.