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da Costa RC, Serrano I, Chambel L, Oliveira M. The importance of "one health approach" to the AMR study and surveillance in Angola and other African countries. One Health 2024; 18:100691. [PMID: 39010949 PMCID: PMC11247297 DOI: 10.1016/j.onehlt.2024.100691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/29/2024] [Indexed: 07/17/2024] Open
Abstract
The dissemination of multidrug-resistant (MDR) bacterial isolates in low- and middle-income countries, including several African countries, is a major concern. The poor sanitary conditions of rural and urban families observed in certain regions may favor the transmission of bacterial infections between animals and humans, including those promoted by strains resistant to practically all available antibiotics. In Angola, in particular, the presence of these strains in human hospitals has already been described. Nevertheless, the information on antimicrobial resistance (AMR) prevalence in Angola is still scarce, especially regarding veterinary isolates. This review aimed to synthesize data on antimicrobial resistance in African countries, with a special focus on Angola, from a One Health perspective. The main goals were to identify research gaps that may require further analysis, and to draw attention to the importance of the conscious use of antimicrobials and the establishment of preventive strategies, aiming to guarantee the safeguarding of public health. To understand these issues, the available literature on AMR in Africa was reviewed. We searched PubMed for articles pertinent to AMR in relevant pathogens in Angola and other African countries. In this review, we focused on AMR rates and surveillance capacity. The principal findings were that, in Africa, especially in sub-Saharan countries, AMR incidence is high due to the lack of legislation on antibiotics, to the close interaction of humans with animals and the environment, and to poverty. The information about current resistance patterns of common pathogenic bacteria is sparse, and the number of quality studies is limited in Angola and in some other Sub-Saharan African countries. Also, studies on the "One Health Approach" focusing on the environment, animals, and humans, are scarce in Africa. The surveillance capacity is minimal, and only a low number of AMR surveillance programs and national health programs are implemented. Most international and cooperative surveillance programs, when implemented, are not properly followed, concluded, nor reported. In Angola, the national health plan does not include AMR control, and there is a consistent omission of data submitted to international surveillance programs. By identifying One Health strengths of each country, AMR can be controlled with a multisectoral approach and governmental commitment.
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Affiliation(s)
- Romay Coragem da Costa
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisboa, Portugal
- Department of Animal Health, Faculty of Veterinary Medicine, University José Eduardo dos Santos, Huambo, Angola
| | - Isa Serrano
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisboa, Portugal
| | - Lélia Chambel
- BioISI-Biosystems and Integrative Sciences Institute, Faculty of Sciences, University of Lisbon, 1749-016 Lisboa, Portugal
| | - Manuela Oliveira
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisboa, Portugal
- cE3c - Centre for Ecology, Evolution and Environmental Changes & CHANGE - Global Change and Sustainability Institute, 1749-016 Lisboa, Portugal
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Tettey R, Egyir B, Tettey P, Arko-Mensah J, Addo SO, Owusu-Nyantakyi C, Boateng W, Fobil J. Genomic analysis of multidrug-resistant Escherichia coli from Urban Environmental water sources in Accra, Ghana, Provides Insights into public health implications. PLoS One 2024; 19:e0301531. [PMID: 38787855 PMCID: PMC11125565 DOI: 10.1371/journal.pone.0301531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/18/2024] [Indexed: 05/26/2024] Open
Abstract
Wastewater discharge into the environment in resource-poor countries poses a threat to public health. Studies in this area within these countries are limited, and the use of high-throughput whole-genome sequencing technologies is lacking. Therefore, understanding of environmental impacts is inadequate. The present study investigated the antibiotic resistance profiles and diversity of beta-lactamases in Escherichia coli strains isolated from environmental water sources in Accra, Ghana. Microbiological analyses were conducted on wastewater samples from three hospitals, a sewage and wastewater treatment plant, and water samples from two urban surface water bodies. Confirmed isolates (N = 57) were selected for phenotypic antibiotic resistance profiles. Multi-drug-resistant isolates (n = 25) were genome sequenced using Illumina MiSeq sequencing technology and screened for sequence types, antibiotic resistance, virulence and beta-lactamase genes, and mobile genetic elements. Isolates were frequently resistant to ampicillin (63%), meropenem (47%), azithromycin (46%), and sulfamethoxazole-trimethoprim (42%). Twenty different sequence types (STs) were identified, including clinically relevant ones such as ST167 and ST21. Five isolates were assigned to novel STs: ST14531 (n = 2), ST14536, ST14537, and ST14538. The isolates belonged to phylogroups A (52%), B1 (44%), and B2 (4%) and carried β-lactamase (TEM-1B, TEM-1C, CTX-M-15, and blaDHA-1) and carbapenemase (OXA-1, OXA-181) resistance genes. Dominant plasmid replicons included Col440I (10.2%) and IncFIB (AP001918) (6.8%). Polluted urban environments in Accra are reservoirs for antibiotic-resistant bacteria, posing a substantial public health risk. The findings underscore the need for targeted public health interventions to mitigate the spread of antibiotic-resistant bacteria and protect public health.
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Affiliation(s)
- Rebecca Tettey
- Department of Biological, Environmental, and Occupational Health Science, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Beverly Egyir
- West African Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Prudence Tettey
- Department of Biological, Environmental, and Occupational Health Science, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - John Arko-Mensah
- Department of Biological, Environmental, and Occupational Health Science, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- West African Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Samuel Ofori Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Christian Owusu-Nyantakyi
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - William Boateng
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Julius Fobil
- West African Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Saeed U, Insaf RA, Piracha ZZ, Tariq MN, Sohail A, Abbasi UA, Fida Rana MS, Gilani SS, Noor S, Noor E, Waheed Y, Wahid M, Najmi MH, Fazal I. Crisis averted: a world united against the menace of multiple drug-resistant superbugs -pioneering anti-AMR vaccines, RNA interference, nanomedicine, CRISPR-based antimicrobials, bacteriophage therapies, and clinical artificial intelligence strategies to safeguard global antimicrobial arsenal. Front Microbiol 2023; 14:1270018. [PMID: 38098671 PMCID: PMC10720626 DOI: 10.3389/fmicb.2023.1270018] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/03/2023] [Indexed: 12/17/2023] Open
Abstract
The efficacy of antibiotics and other antimicrobial agents in combating bacterial infections faces a grave peril in the form of antimicrobial resistance (AMR), an exceedingly pressing global health issue. The emergence and dissemination of drug-resistant bacteria can be attributed to the rampant overuse and misuse of antibiotics, leading to dire consequences such as organ failure and sepsis. Beyond the realm of individual health, the pervasive specter of AMR casts its ominous shadow upon the economy and society at large, resulting in protracted hospital stays, elevated medical expenditures, and diminished productivity, with particularly dire consequences for vulnerable populations. It is abundantly clear that addressing this ominous threat necessitates a concerted international endeavor encompassing the optimization of antibiotic deployment, the pursuit of novel antimicrobial compounds and therapeutic strategies, the enhancement of surveillance and monitoring of resistant bacterial strains, and the assurance of universal access to efficacious treatments. In the ongoing struggle against this encroaching menace, phage-based therapies, strategically tailored to combat AMR, offer a formidable line of defense. Furthermore, an alluring pathway forward for the development of vaccines lies in the utilization of virus-like particles (VLPs), which have demonstrated their remarkable capacity to elicit a robust immune response against bacterial infections. VLP-based vaccinations, characterized by their absence of genetic material and non-infectious nature, present a markedly safer and more stable alternative to conventional immunization protocols. Encouragingly, preclinical investigations have yielded promising results in the development of VLP vaccines targeting pivotal bacteria implicated in the AMR crisis, including Salmonella, Escherichia coli, and Clostridium difficile. Notwithstanding the undeniable potential of VLP vaccines, formidable challenges persist, including the identification of suitable bacterial markers for vaccination and the formidable prospect of bacterial pathogens evolving mechanisms to thwart the immune response. Nonetheless, the prospect of VLP-based vaccines holds great promise in the relentless fight against AMR, underscoring the need for sustained research and development endeavors. In the quest to marshal more potent defenses against AMR and to pave the way for visionary innovations, cutting-edge techniques that incorporate RNA interference, nanomedicine, and the integration of artificial intelligence are currently under rigorous scrutiny.
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Affiliation(s)
- Umar Saeed
- Clinical and Biomedical Research Center (CBRC) and Multidisciplinary Laboratories (MDL), Foundation University School of Health Sciences (FUSH), Foundation University Islamabad (FUI), Islamabad, Pakistan
| | - Rawal Alies Insaf
- Regional Disease Surveillance and Response Unit Sukkur, Sukkur, Sindh, Pakistan
| | - Zahra Zahid Piracha
- International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan
| | | | - Azka Sohail
- Central Park Teaching Hospital, Lahore, Pakistan
| | | | | | | | - Seneen Noor
- International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan
| | - Elyeen Noor
- International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan
| | - Yasir Waheed
- Office of Research, Innovation, and Commercialization (ORIC), Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Maryam Wahid
- Clinical and Biomedical Research Center (CBRC) and Multidisciplinary Laboratories (MDL), Foundation University School of Health Sciences (FUSH), Foundation University Islamabad (FUI), Islamabad, Pakistan
| | - Muzammil Hasan Najmi
- Clinical and Biomedical Research Center (CBRC) and Multidisciplinary Laboratories (MDL), Foundation University School of Health Sciences (FUSH), Foundation University Islamabad (FUI), Islamabad, Pakistan
| | - Imran Fazal
- Clinical and Biomedical Research Center (CBRC) and Multidisciplinary Laboratories (MDL), Foundation University School of Health Sciences (FUSH), Foundation University Islamabad (FUI), Islamabad, Pakistan
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Jesumirhewe C, Cabal-Rosel A, Allerberger F, Springer B, Ruppitsch W. Genetic characterization of Escherichia coli and Klebsiella spp. from humans and poultry in Nigeria. Access Microbiol 2023; 5:acmi000509.v4. [PMID: 37601433 PMCID: PMC10436014 DOI: 10.1099/acmi.0.000509.v4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 05/31/2023] [Indexed: 08/22/2023] Open
Abstract
The emergence of antibiotic resistance in livestock, especially food-producing animals, is of major public health importance as a result of the possibility of these bacteria entering the food chain. In this study, the genetic characteristics of antibiotic-resistant Escherichia coli and Klebsiella spp. isolates from humans and poultry in Edo state, Nigeria, were investigated. In April 2017, 45 Klebsiella spp. and 46 E. coli isolates were obtained from urine, clinical wounds, nasal and chicken faecal samples. Isolates were recovered and identified as previously described. Species identification was achieved by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry and ribosomal multilocus sequence typing. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer method for 12 antibiotics. A double disc synergy test was used to screen for extended-spectrum beta-lactamse (ESBL) production. Whole genome sequencing was performed for strain characterization of the isolates. Thirteen Klebsiella spp. isolates yielded positive results by the ESBL phenotypic test and harboured ESBL genes. Of the 46 E. coli isolates, 21 human and 13 poultry isolates were resistant to at least one of the tested antibiotics. Four human E. coli isolates harboured ESBL genes and revealed positive results when applying ESBL double disc synergy tests. ESBL genes in the Klebsiella spp. and E. coli isolates include bla CTX-M-15 and bla SHV-28. Whole genome-based core gene multilocus sequence typing of the Klebsiella spp. and E. coli isolates revealed a close relatedness among the isolates. An integrated 'One Health' surveillance system is required to monitor transmission of antimicrobial resistance in Nigeria.
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Affiliation(s)
- Christiana Jesumirhewe
- Department of Pharmaceutical Microbiology, College of Pharmacy, Igbinedion University, Okada, Edo state, Nigeria
| | - Adriana Cabal-Rosel
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Franz Allerberger
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Burkhard Springer
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Werner Ruppitsch
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
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Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana. Sci Rep 2022; 12:22069. [PMID: 36543904 PMCID: PMC9772187 DOI: 10.1038/s41598-022-26547-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Bacterial infections caused by multidrug resistant organisms are a major global threat. There is still a knowledge gap on this situation in the Northern Region of Ghana. This study determined the prevalence and resistance profile of bacterial infections. It also identified factors associated with multidrug resistance in the study area. This was a retrospective cross-sectional design and it analyzed data from the samples received at the Tamale Zonal Public Health Reference Laboratory from June 2018 to May 2022. The data were analyzed using the R software version 4.2.0. Univariate and multivariable binary logistic regression analyses were used to determine the factors associated with multidrug resistance. The samples included all specimen types possible. The specimens were collected for the purpose of clinical bacteriology diagnostics. Overall a total of 1222 isolates were obtained. The three (3) main bacteria responsible for infections were: Klebsiella spp. (27%), Moraxella spp. (22%), Escherichia spp. (16%). High resistance levels were found against the tested antibiotics and about 41.60% of the bacterial strains isolated were multidrug resistant. Hospitalization was associated with multidrug resistance in univariate (COR 1.96; 95% CI 1.43-2.71; P-value < 0.001) and multivariable analyses (AOR 1.78; 95% CI 1.28-2.49; P-value < 0.001). There is the need for further research on the molecular epidemiology of antibiotic resistance genes in the study area to effectively control the spread of multidrug resistant pathogens. In addition, efforts to build the capacity of health professionals on infection prevention and control as well as diagnostic and antimicrobial stewardship needs urgent attention.
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Antibiotic-Resistant Bacteria and Resistance Genes in Isolates from Ghanaian Drinking Water Sources. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:2850165. [PMID: 36246472 PMCID: PMC9560817 DOI: 10.1155/2022/2850165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/04/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022]
Abstract
The control of infectious diseases is seriously threatened by the increase in the number of microorganisms resistant to antimicrobial agents. Antibiotic-resistant bacteria have also been identified in the water environment. A field study was performed sampling drinking water sources in seven districts of southern Ghana targeting boreholes, dams, hand-dug wells, and streams during baseflow conditions. Bacteria were isolated (N = 110) from a total of 67 water samples to investigate their antimicrobial susceptibility and to determine their carriage of select antibiotic resistance genes. Bacterial identification was performed using conventional selective media methods and the analytical profile index (API) method. Antibiotic susceptibility tests were carried out using the Kirby–Bauer method. Results indicated that all water sources tested were of poor quality based on the presence of fecal indicator organisms. The most commonly occurring bacterium isolated from water was Klebsiella spp. (N = 24, 21.8%), followed by E. coli (N = 23, 20.9%). Gram-negative bacteria isolates were most commonly resistant to cefuroxime (24.5%), while the Gram-positives were most commonly resistant to meropenem (21.3%). The highest rates of bacterial resistances to more than one antibiotic were observed in Klebsiella spp. (30.0%) followed by E. coli (27.8%). PCR was used to detect the presence of a select antibiotic resistance genes in the Gram-negative isolates. The presence of blaNDM-1, sull, tet(O), and tet(W) were observed in isolates from all water sources. In contrast, ermF was not detected in any of the Gram-negative isolates from any water source. Most (28.7%) of the resistance genes were observed in E. coli isolates. Reducing microbial contamination of the various water sources is needed to protect public health and to ensure the sustainability of this resource. This further calls for education of the citizenry.
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Quarcoo G, Boamah Adomako LA, Abrahamyan A, Armoo S, Sylverken AA, Addo MG, Alaverdyan S, Jessani NS, Harries AD, Ahmed H, Banu RA, Borbor S, Akrong MO, Amonoo NA, Bekoe EMO, Osei-Atweneboana MY, Zachariah R. What Is in the Salad? Escherichia coli and Antibiotic Resistance in Lettuce Irrigated with Various Water Sources in Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12722. [PMID: 36232021 PMCID: PMC9565013 DOI: 10.3390/ijerph191912722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Safety of the environment in which vegetables are grown, marketed and consumed is paramount as most are eaten raw. Irrigation sources include open drains and streams, which are often contaminated with human and animal waste due to poor sanitation infrastructure. In irrigated vegetable farms using such sources in Ghana, we assessed Escherichia coli counts, antibiotic resistance patterns and resistant genes on irrigated lettuce. METHODS A cross-sectional study was conducted between January-May 2022, involving five major vegetable farms in Ghana. RESULTS Escherichia coli was found in all 25 composite lettuce samples analyzed. Counts expressed in CFU/g ranged from 186 to 3000, with the highest counts found in lettuce irrigated from open drains (1670) and tap water using hose pipes (3000). Among all bacterial isolates, resistance ranged between 49% and 70% for the Watch group of antibiotics, 59% for the Reserved group and 82% were multidrug-resistant. Of 125 isolates, 60 (48%) were extended-spectrum beta-lactamase-producing, of which five (8%) had the blaTEM-resistant gene. CONCLUSIONS Lettuce was contaminated with Escherichia coli with high levels of antibiotic resistance. We call on the Ghana Ministry of Food and Agriculture, Food and Drugs Authority and other stakeholders to support farmers to implement measures for improving vegetable safety.
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Affiliation(s)
- Gerard Quarcoo
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, KNUST, Kumasi, Ghana
| | - Lady A. Boamah Adomako
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | | | - Samuel Armoo
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | - Augustina A. Sylverken
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, KNUST, Kumasi, Ghana
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, KNUST, Kumasi, Ghana
| | - Matthew Glover Addo
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, KNUST, Kumasi, Ghana
| | - Sevak Alaverdyan
- Tuberculosis Research and Prevention Center, Yerevan 0014, Armenia
| | - Nasreen S. Jessani
- Centre for Evidence-Based Health Care, Stellenbosch University, Stellenbosch 7602, South Africa
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anthony D. Harries
- International Union against Tuberculosis and Lung Disease, 75001 Paris, France
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Hawa Ahmed
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | - Regina A. Banu
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | - Selorm Borbor
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | - Mark O. Akrong
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | - Nana A. Amonoo
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | - Emmanuel M. O. Bekoe
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | - Mike Y. Osei-Atweneboana
- Council for Scientific and Industrial Research-Water Research Institute, Achimota P.O. Box AH 38, Ghana
| | - Rony Zachariah
- United Nations Children Fund, United Nations Development Programme, World Bank, World Health Organization, Special Programme for Research and Training in Tropical Diseases (TDR) WHO, 20, Avenue Appia, CH-1211 Geneva, Switzerland
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Ahmed H, Zolfo M, Williams A, Ashubwe-Jalemba J, Tweya H, Adeapena W, Labi AK, Adomako LAB, Addico GND, Banu RA, Akrong MO, Quarcoo G, Borbor S, Osei-Atweneboana MY. Antibiotic-Resistant Bacteria in Drinking Water from the Greater Accra Region, Ghana: A Cross-Sectional Study, December 2021-March 2022. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12300. [PMID: 36231603 PMCID: PMC9566567 DOI: 10.3390/ijerph191912300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
With safely managed water accessible to only 19% of the population in Ghana, the majority of its residents are at risk of drinking contaminated water. Furthermore, this water could be a potential vehicle for the transmission of antimicrobial-resistant bacteria. This study assessed the presence of bacteria and the antibiotic resistance profile of Escherichia coli and Pseudomonas aeruginosa in drinking-water sources using membrane filtration and Kirby-Bauer disc diffusion methods. A total of 524 water samples were analyzed for total coliforms, total heterotrophic bacteria, E. coli and P. aeruginosa. Samples included sachets, bottled water, tap water, borehole and well water. Most of the sachet and bottled water samples were within the limits of Ghana's standards for safe drinking water for the parameters tested. Over 50% of tap and borehole water was also free of E. coli and P. aeruginosa. Overall, of 115 E. coli isolates from tap and ground water samples, most were resistant to cefuroxime (88.7%), trimethoprim-sulfamethoxazole (62.6%) and amoxicillin-clavulanate (52.2%). P. aeruginosa isolates were most resistant to aztreonam (48%). Multidrug resistance was predominantly seen among E. coli isolates (58%). Evidence from this study calls for routine antimicrobial resistance surveillance in drinking water across the country and additional treatment of water sources at household levels.
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Affiliation(s)
- Hawa Ahmed
- Council for Scientific and Industrial Research-Water Research Institute (CSIR-WRI), Achimota, Accra P.O. Box AH 38, Ghana
| | - Maria Zolfo
- Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Anita Williams
- MSF Luxembourg Operational Research (LuxOR) Unit, L-1617 Luxembourg, Luxembourg
| | | | - Hannock Tweya
- Malawi International Training and Education Center for Health (Malawi-I-TECH), Lilongwe 3, Lilongwe P.O. Box 30369, Malawi
| | - Wisdom Adeapena
- Kintampo Health Research Centre, Kintampo P.O. Box 200, Bono East, Ghana
| | - Appiah-Korang Labi
- WHO Country Office, 7 Ameda Street, Roman Ridge, Accra P.O. Box MB 142, Ghana
| | - Lady A. B. Adomako
- Council for Scientific and Industrial Research-Water Research Institute (CSIR-WRI), Achimota, Accra P.O. Box AH 38, Ghana
| | - Gloria N. D. Addico
- Council for Scientific and Industrial Research-Water Research Institute (CSIR-WRI), Achimota, Accra P.O. Box AH 38, Ghana
| | - Regina A. Banu
- Council for Scientific and Industrial Research-Water Research Institute (CSIR-WRI), Achimota, Accra P.O. Box AH 38, Ghana
| | - Mark O. Akrong
- Council for Scientific and Industrial Research-Water Research Institute (CSIR-WRI), Achimota, Accra P.O. Box AH 38, Ghana
| | - Gerard Quarcoo
- Council for Scientific and Industrial Research-Water Research Institute (CSIR-WRI), Achimota, Accra P.O. Box AH 38, Ghana
| | - Selorm Borbor
- Council for Scientific and Industrial Research-Water Research Institute (CSIR-WRI), Achimota, Accra P.O. Box AH 38, Ghana
| | - Mike Y. Osei-Atweneboana
- Council for Scientific and Industrial Research-Water Research Institute (CSIR-WRI), Achimota, Accra P.O. Box AH 38, Ghana
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Hein W, Aglanu LM, Mensah-Sekyere M, Harant A, Brinkel J, Lamshöft M, Lorenz E, Eibach D, Amuasi J. Fighting Antimicrobial Resistance: Development and Implementation of the Ghanaian National Action Plan (2017–2021). Antibiotics (Basel) 2022; 11:antibiotics11050613. [PMID: 35625257 PMCID: PMC9137880 DOI: 10.3390/antibiotics11050613] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022] Open
Abstract
In recent years, Ghana has been recognised as a leading player in addressing antimicrobial resistance (AMR) in Africa. However, based on our literature review, we could not ascertain whether the core elements of the national action plan (NAP) were implemented in practice. In this paper, we present a qualitative analysis of the development of AMR-related policies in Ghana, including the NAP. We conducted 13 semi-structured expert interviews to obtain at a more thorough understanding of the implementation process for the AMR NAP and to highlight its accomplishments and shortcomings. The results show that AMR policies, as embodied in the NAP, have led to an extended network of cooperation between stakeholders in many political fields. Broadly, limited allocation of financial resources from the government and from international cooperation have been deplored. Furthermore, the opportunity for using the NAP in mainstreaming the response to the threat of AMR has not been seized. To the general public, this remained hidden behind a number of other relevant health topics such as infection prevention, veterinary services and pharmaceutical regulation. As a One Health (OH) challenge, developing countries could integrate AMR NAPs into other health and environmental programmes to improve its implementation in practice.
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Affiliation(s)
- Wolfgang Hein
- German Institute of Global and Area Studies (GIGA), 20354 Hamburg, Germany
- Faculty of Business, Economics and Social Sciences, University of Hamburg, 20146 Hamburg, Germany;
- Correspondence:
| | - Leslie Mawuli Aglanu
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), PMB UPO, Kumasi, Ghana; (L.M.A.); (J.A.)
- University Medical Centre Groningen (UMCG), University of Groningen, 9713 GZ Groningen, The Netherlands
| | | | - Anne Harant
- Faculty of Business, Economics and Social Sciences, University of Hamburg, 20146 Hamburg, Germany;
| | - Johanna Brinkel
- Bernhard Nocht Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.B.); (M.L.); (E.L.)
- German Centre for Infection Research (DZIF), 20354 Hamburg, Germany
| | - Maike Lamshöft
- Bernhard Nocht Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.B.); (M.L.); (E.L.)
- German Centre for Infection Research (DZIF), 20354 Hamburg, Germany
| | - Eva Lorenz
- Bernhard Nocht Institute for Tropical Medicine (BNITM), 20359 Hamburg, Germany; (J.B.); (M.L.); (E.L.)
- German Centre for Infection Research (DZIF), 20354 Hamburg, Germany
| | - Daniel Eibach
- Federal Ministry for Economic Cooperation and Development (Germany), 53113 Bonn, Germany;
| | - John Amuasi
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), PMB UPO, Kumasi, Ghana; (L.M.A.); (J.A.)
- Kwame Nkrumah University of Science and Technology (KNUST), PMB UPO, Kumasi, Ghana;
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Kichana E, Addy F, Dufailu OA. Genetic characterization and antimicrobial susceptibility of Escherichia coli isolated from household water sources in northern Ghana. JOURNAL OF WATER AND HEALTH 2022; 20:770-780. [PMID: 35635771 DOI: 10.2166/wh.2022.197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The microbial quality of household water is an important issue in developing countries, especially in Ghana, where many people still depend on unimproved sources of water. The present study investigated the prevalence, genetic characteristics, and antimicrobial resistance profile of Escherichia coli from surface water sources. Fifty-two water samples were analyzed by using a spread plate, a biochemical test, and multiplex polymerase chain reactions. E. coli was isolated from each of the 52 water samples. Of these isolates, 75% were noted to possess virulence genes. Approximately 54% of the isolates were characterized as follows: enterotoxigenic E. coli (ETEC, 10.26%), enteropathogenic E. coli (EPEC, 17.95%), verotoxigenic E. coli (VTEC, 23.07%), and enteroinvasive E. coli (EIEC, 2.57%). Eighteen of the fifty-two isolates could not be characterized due to heterogeneity in banding. The disc diffusion method was used to test for antimicrobial susceptibility. The isolates were most resistant to ceftazidime, augmentin, and cefuroxime. Multidrug resistance was recorded in 48.1% of the isolates. In contrast, the isolates were most susceptible to ciprofloxacin (86.5%), nitrofurantoin (84.6%), and ofloxacin (75%). These results revealed a high diversity and widespread of E. coli in northern Ghana. The study provides important data for public health nationwide surveillance of E. coli in surface water across the country.
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Affiliation(s)
- Elvis Kichana
- Regional Water Quality Laboratory, World Vision Ghana, No. 3 Kotei Robertson Road, North Industrial Area, North Kaneshie, PMB Accra, Ghana E-mail:
| | - Francis Addy
- Department of Biotechnology, University for Development Studies, Tamale NL-1142-8658, Ghana
| | - Osman Adamu Dufailu
- Department of Microbiology, University for Development Studies, Tamale NL-1142-8658, Ghana
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Mensah GI, Adjei VY, Vicar EK, Atsu PS, Blavo DL, Johnson SAM, Addo KK. Safety of Retailed Poultry: Analysis of Antibiotic Resistance in Escherichia coli From Raw Chicken and Poultry Fecal Matter From Selected Farms and Retail Outlets in Accra, Ghana. Microbiol Insights 2022; 15:11786361221093278. [PMID: 35521227 PMCID: PMC9067029 DOI: 10.1177/11786361221093278] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose: To assess the safety of retailed poultry using the prevalence of antibiotic resistance in Escherichia coli ( E. coli), a dominant intestinal microflora. Methods: Two medium-scale farms and 8 well-known retail outlets within the La-Nkwantanang Madina municipality in Accra were purposively selected for sampling from January to March 2020. We randomly sampled raw chicken (n = 25) and poultry fecal matter (n = 50). All samples were immediately transported on ice to the laboratory for analysis within 12 hours after collection. Conventional culture techniques, biochemical tests, and matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF-MS) were used for isolation and identification. The antimicrobial susceptibility of isolated E. coli strains (n = 36) was tested using the Kirby Bauer disk diffusion method. Results: Antimicrobial resistance in E. coli ranged from 10.7 % (cefotaxime) to 82.1% (tetracycline) in fecal matter and 0% (gentamicin & cefotaxime) to 62.5% (tetracycline) in chicken. The prevalence of antimicrobial resistant E. coli in fecal samples was higher than in chicken for almost all antibiotics tested, except for cefoxitin, cefuroxime, and ceftazidime. Multidrug resistance was 57.1% in E. coli from fecal samples compared to 62.5% in chicken. Conclusion: The high level of resistance to E. coli in fecal matter is of public health concern because cross-contamination often occurs during slaughter and processing. This calls for close surveillance and strict adherence to Hazard Analysis and Critical Control Point (HACCP) principles in the chicken production chain to prevent the transmission of antimicrobial-resistant E. coli strains through the food chain.
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Affiliation(s)
- Gloria Ivy Mensah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Vida Yirenkyiwaa Adjei
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- Institute for Environment and Sanitation Studies, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Ezekiel Kofi Vicar
- Department of Clinical Microbiology, University for Development Studies, Tamale, Ghana
| | - Prince Sedinam Atsu
- School of Veterinary Medicine, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - David Livingstone Blavo
- School of Veterinary Medicine, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Sherry Ama Mawuko Johnson
- School of Veterinary Medicine, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kennedy Kwasi Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Reduced Bacterial Counts from a Sewage Treatment Plant but Increased Counts and Antibiotic Resistance in the Recipient Stream in Accra, Ghana-A Cross-Sectional Study. Trop Med Infect Dis 2021; 6:tropicalmed6020079. [PMID: 34068850 PMCID: PMC8163181 DOI: 10.3390/tropicalmed6020079] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 12/27/2022] Open
Abstract
Wastewater treatment plants receive sewage containing high concentrations of bacteria and antibiotics. We assessed bacterial counts and their antibiotic resistance patterns in water from (a) influents and effluents of the Legon sewage treatment plant (STP) in Accra, Ghana and (b) upstream, outfall, and downstream in the recipient Onyasia stream. We conducted a cross-sectional study of quality-controlled water testing (January–June 2018). In STP effluents, mean bacterial counts (colony-forming units/100 mL) had reduced E. coli (99.9% reduction; 102,266,667 to 710), A. hydrophila (98.8%; 376,333 to 9603), and P. aeruginosa (99.5%; 5,666,667 to 1550). Antibiotic resistance was significantly reduced for tetracycline, ciprofloxacin, cefuroxime, and ceftazidime and increased for gentamicin, amoxicillin/clavulanate, and imipenem. The highest levels were for amoxicillin/clavulanate (50–97%) and aztreonam (33%). Bacterial counts increased by 98.8% downstream compared to the sewage outfall and were predominated by E. coli, implying intense fecal contamination from other sources. There was a progressive increase in antibiotic resistance from upstream, to outfall, to downstream. The highest resistance was for amoxicillin/clavulanate (80–83%), cefuroxime (47–73%), aztreonam (53%), and ciprofloxacin (40%). The STP is efficient in reducing bacterial counts and thus reducing environmental contamination. The recipient stream is contaminated with antibiotic-resistant bacteria listed as critically important for human use, which needs addressing.
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