Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana.

Autor: Obeng-Nkrumah N; Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana., Korang-Labi A; Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana., Kwao P; Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana., Egyir B; Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana., Nuertey BD; Community Health Department, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana., Hedidor G; World Health Organization- Ghana Office, Ghana., Boateng G; National Public Health and Reference Laboratory, Korle Bu, Ghana., Asah-Opoku K; Department of Obstetrics and Gynaecology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana., Dankwah T; Department of Microbiology, Korle Bu Teaching Hospital, Korle Bu, Ghana., Okine E; Department of Microbiology, Korle Bu Teaching Hospital, Korle Bu, Ghana., Opintan JA; Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Nov 11; Vol. 19 (11), pp. e0310058. Date of Electronic Publication: 2024 Nov 11 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0310058
Abstrakt: Background: Vulnerable groups, such as pregnant women, are at increased risk of potentially life-threatening infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) for both mother and newborn. However, data regarding ESBL-E carriage and associated risk factors in Ghanaian pregnant women remain scarce.
Objective: This study aimed to determine the prevalence of ESBL-E carriage and its associated risk factors among pregnant women attending the antenatal clinic at the Korle Bu Teaching Hospital.
Methods: A systematic sample of 700 pregnant women with gestational age ≥ 34 weeks attending the antenatal clinic at Korle Bu Teaching Hospital was included in the study. After administering a structured questionnaire to assess potential risk factors associated with ESBL-E carriage, patients were given a sterile stool container to submit at least 1 g of stool specimen. Recovered isolates from faecal specimens were identified using MALDI-TOF-MS technology. These isolates were then subjected to susceptibility testing and ESBL identification. A random subset of 24 ESBL-producing Escherichia coli isolates was whole-genome sequenced on the MiSeq Illumina platform. Risk factors associated with ESBL-E carriage were determined using multivariable logistic regression analysis.
Results: Among the 700 pregnant women, 42% (294) carried ESBL-E. The predominant ESBL-producing Enterobacterales were Escherichia coli (95%). Fifty percent (50%) of ESBL-E were multidrug resistant isolates (MDRs). Whole-genome sequencing of 24 ESBL-producing E. coli isolates revealed that blaCTX-M-15 (96%) was the most prevalent ESBL gene type. Notably, most isolates belonged to commensal phylogenetic groups (A, B1, and C; 88%). Having a primary level of education (aOR 1.45, 95% CI 1.05-1.96) and consuming legumes as the main source of protein (aOR 0.17, 0.40-0.83) were significantly associated with intestinal carriage of ESBL-E.
Conclusion: This study identified a high prevalence of ESBL-E and MDR-ESBL-E carriage among pregnant women. Our findings underscore the urgent need for public health interventions to control the spread of AMR.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Obeng-Nkrumah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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