Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana.
<h4>Background</h4>Chronic infected wounds are generally difficult to manage and treatment can be particularly challenging in resource-limited settings where diagnostic testing is not readily available. In this study, the epidemiology of microbial pathogens in chronically infected wounds...
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doaj-74cd5ff1e5a1407587c0755b526e5b7d2021-03-04T11:15:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01158e023726310.1371/journal.pone.0237263Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana.Ralf KrumkampKwabena OppongBenedikt HoganRicardo StraussHagen FrickmannCharity Wiafe-AkentenKennedy G BoahenVolker RickertsIlka McCormick SmithUwe GroßMarco SchulzeAnna JaegerUlrike LoderstädtNimako SarpongEllis Owusu-DaboJürgen MayDenise Dekker<h4>Background</h4>Chronic infected wounds are generally difficult to manage and treatment can be particularly challenging in resource-limited settings where diagnostic testing is not readily available. In this study, the epidemiology of microbial pathogens in chronically infected wounds in rural Ghana was assessed to support therapeutic choices for physicians.<h4>Methods</h4>Culture-based bacterial diagnostics including antimicrobial resistance testing were performed on samples collected from patients with chronic wounds at a hospital in Asante Akim North Municipality, Ghana. Fungal detection was performed by broad-range fungal PCR and sequencing of amplicons.<h4>Results</h4>In total, 105 patients were enrolled in the study, from which 207 potential bacterial pathogens were isolated. Enterobacteriaceae (n = 84, 41%) constituted the most frequently isolated group of pathogens. On species level, Pseudomonas aeruginosa (n = 50, 24%) and Staphylococcus aureus (n = 28, 14%) were predominant. High resistance rates were documented, comprising 29% methicillin resistance in S. aureus as well as resistance to 3rd generation cephalosporins and fluoroquinolones in 33% and 58% of Enterobacteriaceae, respectively. One P. aeruginosa strain with carbapenem resistance was identified. The most frequently detected fungi were Candida tropicalis.<h4>Conclusions</h4>The pathogen distribution in chronic wounds in rural Ghana matched the internationally observed patterns with a predominance of P. aeruginosa and S. aureus. Very high resistance rates discourage antibiotic therapy but suggest an urgent need for microbiological diagnostic approaches, including antimicrobial resistance testing to guide the management of patients with chronic wounds in Ghana.https://doi.org/10.1371/journal.pone.0237263 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ralf Krumkamp Kwabena Oppong Benedikt Hogan Ricardo Strauss Hagen Frickmann Charity Wiafe-Akenten Kennedy G Boahen Volker Rickerts Ilka McCormick Smith Uwe Groß Marco Schulze Anna Jaeger Ulrike Loderstädt Nimako Sarpong Ellis Owusu-Dabo Jürgen May Denise Dekker |
spellingShingle |
Ralf Krumkamp Kwabena Oppong Benedikt Hogan Ricardo Strauss Hagen Frickmann Charity Wiafe-Akenten Kennedy G Boahen Volker Rickerts Ilka McCormick Smith Uwe Groß Marco Schulze Anna Jaeger Ulrike Loderstädt Nimako Sarpong Ellis Owusu-Dabo Jürgen May Denise Dekker Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana. PLoS ONE |
author_facet |
Ralf Krumkamp Kwabena Oppong Benedikt Hogan Ricardo Strauss Hagen Frickmann Charity Wiafe-Akenten Kennedy G Boahen Volker Rickerts Ilka McCormick Smith Uwe Groß Marco Schulze Anna Jaeger Ulrike Loderstädt Nimako Sarpong Ellis Owusu-Dabo Jürgen May Denise Dekker |
author_sort |
Ralf Krumkamp |
title |
Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana. |
title_short |
Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana. |
title_full |
Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana. |
title_fullStr |
Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana. |
title_full_unstemmed |
Spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in Ghana. |
title_sort |
spectrum of antibiotic resistant bacteria and fungi isolated from chronically infected wounds in a rural district hospital in ghana. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2020-01-01 |
description |
<h4>Background</h4>Chronic infected wounds are generally difficult to manage and treatment can be particularly challenging in resource-limited settings where diagnostic testing is not readily available. In this study, the epidemiology of microbial pathogens in chronically infected wounds in rural Ghana was assessed to support therapeutic choices for physicians.<h4>Methods</h4>Culture-based bacterial diagnostics including antimicrobial resistance testing were performed on samples collected from patients with chronic wounds at a hospital in Asante Akim North Municipality, Ghana. Fungal detection was performed by broad-range fungal PCR and sequencing of amplicons.<h4>Results</h4>In total, 105 patients were enrolled in the study, from which 207 potential bacterial pathogens were isolated. Enterobacteriaceae (n = 84, 41%) constituted the most frequently isolated group of pathogens. On species level, Pseudomonas aeruginosa (n = 50, 24%) and Staphylococcus aureus (n = 28, 14%) were predominant. High resistance rates were documented, comprising 29% methicillin resistance in S. aureus as well as resistance to 3rd generation cephalosporins and fluoroquinolones in 33% and 58% of Enterobacteriaceae, respectively. One P. aeruginosa strain with carbapenem resistance was identified. The most frequently detected fungi were Candida tropicalis.<h4>Conclusions</h4>The pathogen distribution in chronic wounds in rural Ghana matched the internationally observed patterns with a predominance of P. aeruginosa and S. aureus. Very high resistance rates discourage antibiotic therapy but suggest an urgent need for microbiological diagnostic approaches, including antimicrobial resistance testing to guide the management of patients with chronic wounds in Ghana. |
url |
https://doi.org/10.1371/journal.pone.0237263 |
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