Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 24, Number 5—May 2018
Dispatch

Antimicrobial-Resistant Bacteria in Infected Wounds, Ghana, 20141

Hauke Janssen2, Iryna Janssen2, Paul Cooper, Clemens Kainyah, Theresia Pellio, Michael Quintel, Mathieu Monnheimer, Uwe Groß, and Marco H. SchulzeComments to Author 
Author affiliations: University Medical Center Goettingen, Goettingen, Germany (H. Janssen, I. Janssen, M. Quintel, M. Monnheimer, U. Groß, M.H. Schulze); St. Martin de Porres Hospital, Eikwe, Ghana (P. Cooper, C. Kainyah, T. Pellio)

Main Article

Table 1

Percentages of antimicrobial drug resistance in selected bacterial species in wound infections, Ghana, 2014*

Drug % Resistant
Staphylococcus aureus, n = 31 Enterococcus faecalis, n = 21 Proteus mirabilis, n = 20 Escherichia coli, n = 19 Klebsiella pneumoniae, n = 13 Enterobacter cloacae complex, n = 10 Pseudomonas aeruginosa, n = 20 Acinetobacter. baumannii complex, n = 8
PEN 93.5
AMP 0 70.0 94.7 100 100
OXA 0
SAM 0 45.0 82.2 69.2 100
TZP 0 10.5 46.2 30.0 10.0
CXM 5.0 57.9 46.2 80.0
CTX 5.0 47.4 46.2 40.0
CAZ 5.0 47.4 46.2 40.0 5.0 37.5†
IPM 0 0
MEM 0 0 0 0 5.0 0
ERY 3.2 100
CLI 3.2 100
TET 67.7 100
GEN 3.2 15.0 46.2 46.2 40.0 10.0 62.5
AMI 0 0
CIP 20.0 46.2 46.2 30.0 15.0 37.5
LVX 0
SXT 32.3 100 75.0 69.2 69.2 50.0
FOF 0
RIF 0
VAN 0 0

*Antimicrobial susceptibility testing was performed with VITEK 2 (bioMérieux, Marcy-l'Étoile, France) according to the EUCAST breakpoint tables for interpretation of MICs, version 4.0, 2014 (7). Blank cells indicate no testing performed. AMI, amikacin; AMP, ampicillin; CAZ, ceftazidime; CIP, ciprofloxacin; CLI, clindamycin; CTX, cefotaxime; CXM, cefuroxime; ERY, erythromycin; FOF, fosfomycin; GEN, gentamicin; IPM, imipenem; LVX, levofloxacin; MEM, meropenem; OXA, oxacillin; PEN, penicillin; RIF, rifampin; SAM, ampicillin/sulbactam; SXT, trimethoprim/sulfamethoxazole; TET, tetracycline; TZP, piperacillin/tazobactam; VAN, vancomycin.
†The interpretation of the CAZ MIC for A. baumannii complex followed the recommendations of the Clinical and Laboratory Standards Institute performance standards for antimicrobial susceptibility testing (8).

Main Article

References
  1. Vernet  G, Mary  C, Altmann  DM, Doumbo  O, Morpeth  S, Bhutta  ZA, et al. Surveillance for antimicrobial drug resistance in under-resourced countries. Emerg Infect Dis. 2014;20:434–41. DOIPubMedGoogle Scholar
  2. Gross  U, Amuzu  SK, de Ciman  R, Kassimova  I, Gross  L, Rabsch  W, et al. Bacteremia and antimicrobial drug resistance over time, Ghana. Emerg Infect Dis. 2011;17:1879–82. DOIPubMedGoogle Scholar
  3. Kumburu  HH, Sonda  T, Mmbaga  BT, Alifrangis  M, Lund  O, Kibiki  G, et al. Patterns of infections, aetiological agents and antimicrobial resistance at a tertiary care hospital in northern Tanzania. Trop Med Int Health. 2017;22:454–64. DOIPubMedGoogle Scholar
  4. Sen  CK, Gordillo  GM, Roy  S, Kirsner  R, Lambert  L, Hunt  TK, et al. Human skin wounds: a major and snowballing threat to public health and the economy. Wound Repair Regen. 2009;17:763–71. DOIPubMedGoogle Scholar
  5. Leopold  SJ, van Leth  F, Tarekegn  H, Schultsz  C. Antimicrobial drug resistance among clinically relevant bacterial isolates in sub-Saharan Africa: a systematic review. J Antimicrob Chemother. 2014;69:2337–53. DOIPubMedGoogle Scholar
  6. Cheesbrough  M. District laboratory practice in tropical countries. Part 2. 2nd ed. Cambridge (UK): Cambridge University Press; 2006.
  7. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0. 2014 [cited 2017 Sep 9]. http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/Breakpoint_table_v_4.0.pdf
  8. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: twenty-fourth informational supplement (M100–S24). Wayne (PA): The Institute; 2014.
  9. Nwankwo  E, Edino  S. Seasonal variation and risk factors associated with surgical site infection rate in Kano, Nigeria. Turk J Med Sci. 2014;44:674–80. DOIPubMedGoogle Scholar
  10. Ntirenganya  C, Manzi  O, Muvunyi  CM, Ogbuagu  O. High prevalence of antimicrobial resistance among common bacterial isolates in a tertiary healthcare facility in Rwanda. Am J Trop Med Hyg. 2015;92:865–70. DOIPubMedGoogle Scholar
  11. Manyahi  J, Matee  MI, Majigo  M, Moyo  S, Mshana  SE, Lyamuya  EF. Predominance of multi-drug resistant bacterial pathogens causing surgical site infections in Muhimbili National Hospital, Tanzania. BMC Res Notes. 2014;7:500. DOIPubMedGoogle Scholar
  12. Mengesha  RE, Kasa  BG, Saravanan  M, Berhe  DF, Wasihun  AG. Aerobic bacteria in post surgical wound infections and pattern of their antimicrobial susceptibility in Ayder Teaching and Referral Hospital, Mekelle, Ethiopia. BMC Res Notes. 2014;7:575. DOIPubMedGoogle Scholar
  13. Falagas  ME, Karageorgopoulos  DE, Leptidis  J, Korbila  IP. MRSA in Africa: filling the global map of antimicrobial resistance. PLoS One. 2013;8:e68024. DOIPubMedGoogle Scholar
  14. Morgan  DJ, Okeke  IN, Laxminarayan  R, Perencevich  EN, Weisenberg  S. Non-prescription antimicrobial use worldwide: a systematic review. Lancet Infect Dis. 2011;11:692–701. DOIPubMedGoogle Scholar
  15. Elder  DP, Kuentz  M, Holm  R. Antibiotic resistance: the need for a global strategy. J Pharm Sci. 2016;105:2278–87. DOIPubMedGoogle Scholar

Main Article

1Preliminary results from this study were presented at the Annual Meeting of the German Society of Tropical Medicine and International Health; October 7–8, 2016; Bonn, Germany; and at the 69th Annual Meeting of the German Society for Hygiene and Microbiology; March 5–8, 2017; Wuerzburg, Germany.

2These authors contributed equally to this article.

Page created: April 17, 2018
Page updated: April 17, 2018
Page reviewed: April 17, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external