23 results on '"Mercy J. Newman"'
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2. Pneumococcal carriage among children under five in Accra, Ghana, five years after the introduction of pneumococcal conjugate vaccine
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Nicholas T. K. D. Dayie, Elizabeth Y. Tettey, Mercy J. Newman, Elizabeth Bannerman, Eric S. Donkor, Appiah-Korang Labi, and Hans-Christian Slotved
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Streptococcus pneumoniae ,Ghana ,Carriage ,Serotype ,PCV-13 ,Pediatrics ,RJ1-570 - Abstract
Abstract Background The study objective was to determine the carriage and serotype distribution of Streptococcus pneumoniae among children in Accra, Ghana, five years after the introduction of the pneumococcal conjugate vaccine (PCV-13) in 2012. Methods Nasopharyngeal swab samples were collected from 410 children below 5 years of age in Accra, Ghana, from September to December, 2016. Pneumococcal isolates were identified by optochin sensitivity and bile solubility. Serotyping was performed using the latex agglutination kit and Quellung reaction. The isolates were furthermore tested for antimicrobial susceptibility for different antimicrobials, including penicillin (PEN). Twelve isolates including seven non-typeable (NT) isolates were characterized using whole-genome sequencing analysis (WGS). Results The overall carriage prevalence was found to be 54% (95% CI, 49–59%), and 20% (95% CI, 49–59%) of the children were carrying PCV-13 included serotypes, while 37% (95% CI, 33–42%) of the children were carrying non-PCV-13 serotypes. Based on the serotype distribution, 33% of all observed serotypes were included in PCV-13 while 66% were non-PCV-13 serotypes. The dominating non-PCV-13 serotypes were 23B, 16F, and 11A followed by PCV-13 serotypes 23F and 19F. The PCV-13 covers the majority of resistant isolates in Accra. A proportion of 22.3% of the isolates showed intermediate resistance to penicillin G, while only one isolate showed full resistance. Forty-five isolates (20.5%) were defined as multidrug-resistant (MDR) as they were intermediate/resistant to three or more classes of antimicrobials. Of the seven NT isolates characterized by WGS, four showed highest match to genotype 38, while the remaining three showed highest match to genotype 14. Four MDR serotype 19A isolates were found to be MLST 320. Conclusion PCV-13 introduced in Ghana did not eliminate PCV-13 covered serotypes, and the carriage rate of 54% in this study is similar to carriage studies from pre PCV-13 period. However, the penicillin non-susceptible isolates have been reduced from 45% of carriage isolates before PCV-13 introduction to 22.3% of the isolates in this study. Continuous monitoring of serotype distribution is important, and in addition, an evaluation of an alternative vaccination schedule from 3 + 0 to 2 + 1 will be important to consider. more...
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- 2019
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3. Physicians’ knowledge, attitudes, and perceptions concerning antibiotic resistance: a survey in a Ghanaian tertiary care hospital
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Appiah-Korang Labi, Noah Obeng-Nkrumah, Stephanie Bjerrum, Nii Armah Adu Aryee, Yaw Adjei Ofori-Adjei, Alfred E. Yawson, and Mercy J. Newman
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Views ,Antibiotic resistance ,Antibiotics ,Physicians ,Ghana ,Korle-Bu Teaching Hospital ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Understanding the knowledge, attitudes and practices of physicians towards antibiotic resistance is key to developing interventions aimed at behavior change. The survey aimed to investigate physicians’ knowledge and attitudes towards antibiotic resistance in a tertiary-care hospital setting in Ghana. Methods We conducted a cross-sectional respondent-driven survey using a 40-item, anonymous, voluntary, traditional paper-and-pencil self-administered questionnaire among 159 physicians at Korle-Bu Teaching Hospital. Single and multi-factor analysis were conducted to assess the study objectives. Results The survey was completed by 159 of 200 physicians (response rate of 79.5%). Of physicians, 30.1% (47/156) perceived antibiotic resistance as very important global problem, 18.5% (29/157) perceived it as very important national problem and only 8.9% (14/157) thought it as a very important problem in their hospital. Methicillin resistant Staphylococcus aureus was the most known about antibiotic resistant bacteria of public health importance followed by extended-spectrum beta-lactamase-producing Enterobacteriaceae, carbapenem resistant Enterobacteriaceae (CRE) and vancomycin resistant enterococci (VRE). In multiple logistic regression analysis, senior physicians were nearly 3 times more likely to know about CRE than junior physicians. The odds of knowing about VRE increased over 4.5 times from being a junior to becoming senior physician. Among junior physicians, age had no associated effect on their knowledge of VRE or CRE. Conclusions Physicians in this survey showed variable knowledge and perceptions on antibiotic resistance. Introducing educational programs on antibiotic resistance would be a useful intervention and should focus on junior physicians. more...
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- 2018
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4. Antibiotic use in a tertiary healthcare facility in Ghana: a point prevalence survey
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Appiah-Korang Labi, Noah Obeng-Nkrumah, Edmund Tetteh Nartey, Stephanie Bjerrum, Nii Armah Adu-Aryee, Yaw Adjei Ofori-Adjei, Alfred E. Yawson, and Mercy J. Newman
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Antibiotic ,Ghana ,Africa ,Point prevalence ,Antibiotic stewardship ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The global rise and spread of antibiotic resistance is limiting the usefulness of antibiotics in the prevention and treatment of infectious diseases. The use of antibiotic stewardship programs guided by local data on prescribing practices is a useful strategy to control and reduce antibiotic resistance. Our objective in this study was to determine the prevalence and indications for use of antibiotics at the Korle-Bu Teaching Hospital Accra, Ghana. Methods An antibiotic point prevalence survey was conducted among inpatients of the Korle-Bu Teaching Hospital between February and March 2016. Folders and treatment charts of patients on admission at participating departments were reviewed for antibiotics administered or scheduled to be administered on the day of the survey. Data on indication for use were also collected. Prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of survey by the total number of patients on admission. Results Of the 677 inpatients surveyed, 348 (51.4%, 95% CI, 47.6–55.2) were on treatment with antibiotics. Prevalence was highest among Paediatric surgery where 20/22 patients (90.9%, 95% CI, 70.8–98.9) were administered antibiotics and lowest among Obstetrics patients with 77/214 (36%, 95% CI, 29.5–42.8). The indications for antibiotic use were 245/611 (40.1%) for community-acquired infections, 205/611 (33.6%) for surgical prophylaxis, 129/611 (21.1%) for healthcare associated infections and 33/611 (5.4%) for medical prophylaxis. The top five antibiotics prescribed in the hospital were metronidazole 107 (17.5%), amoxicillin-clavulinic acid 82 (13.4%), ceftriaxone 17(12.1%), cefuroxime 61 (10.0%), and cloxacillin 52 (8.5%) respectively. Prevalence of meropenem and vancomycin use was 12(2%) and 1 (.2%) respectively. The majority of patients 181 (52%) were being treated with two antibiotics. Conclusion This study indicated a high prevalence of antibiotic use among inpatients at the Korle-Bu Teaching Hospital. Metronidazole was the most commonly used antibiotic; mainly for surgical prophylaxis. There is the need to further explore factors contributing to the high prevalence of antibiotic use and develop strategies for appropriate antibiotic use in the hospital. more...
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- 2018
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5. In Vitro Susceptibility of Mycobacterium ulcerans Isolates to Selected Antimicrobials
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Enid Owusu, Mercy J. Newman, Kwesi K. Addo, and Phyllis Addo
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Infectious and parasitic diseases ,RC109-216 ,Microbiology ,QR1-502 - Abstract
Background. The current definitive treatment of Buruli ulcer with antibiotics makes the issue of antimicrobial drug resistance an unavoidable one. This is as a result of drug misuse by health personnel and patients’ noncompliance to treatment regimen. Monitoring of these factors and screening for new effective antimicrobials are crucial to effective management of Buruli ulcer disease. This study therefore investigated the inhibitory activity of some antibiotics against isolates of Mycobacterium ulcerans. Methods. Activity of eight antibiotics was tested against twelve M. ulcerans isolates (2 reference strains and 10 clinical isolates). The anti-M. ulcerans activities were determined by the agar dilution method and the minimum inhibitory concentrations (MICs) were determined by the agar proportion method. Results. All antimicrobials investigated had activity against M. ulcerans isolates tested. The MICs ranged from 0.16 μg/mL to 2.5 μg/mL. Azithromycin recorded the highest inhibitory activity at a mean MIC of 0.39 μg/mL, whilst clofazimine a second-line antileprosy drug, recorded the lowest at a mean MIC of 2.19 μg/mL. Among the four antituberculosis drugs, rifampicin had the highest activity with a mean MIC of 0.81 μg/mL. Conclusion. Azithromycin could be considered as a lucrative alternative to existing treatment methods for inhibiting M. ulcerans in Ghana. more...
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- 2017
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6. Prevalence and antibiotic susceptibility profile of methicillin resistant Staphylococcus aureus in Accra, Ghana
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Stephen T. Odonkor, Mercy J. Newman, and Kennedy K. Addo
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Methicillin resistant Staphylococcus aureus (MRSA), mecA gene, penicillin-binding protein 2a (PBP 2a), β-lactam, antibiotics ,Microbiology ,QR1-502 - Abstract
Over the last four decades, methicillin-resistant Staphylococcus aureus (MRSA) has spread throughout the world and become highly endemic in many geographical areas. This pathogen causes severe morbidity and mortality in hospitals worldwide. MRSA is also considered a major community acquired pathogen throughout the world. MRSA is implicated in serious clinical conditions such as bacteremia, pneumonia, and intra-abdominal infection. The objective of this study was to determine the prevalence of MRSA in Accra, Ghana, and also to determine its antibiotic susceptibility profile. Two hundred and fifty Staphylococcus aureus isolates from routine microbiological specimens were collected from five hospitals in Accra. MRSA screening assay was used to screen for MRSA. Disc diffusion method (Kirby-Bauer) was used to determine the susceptibility of the MRSA. The MRSA screening assay, which is very close to the polymerase chain reaction in terms of specificity and sensitivity, showed that 84 of the 250 isolates were MRSA, giving a prevalence rate of 33.6%. MRSA strains were susceptible to erythromycin; 63 out of the 84 MRSA isolates were susceptible representing 75%. This was followed by gentamicin 46 (54.7%), cotrimoxazole 35 (49%), cefuroxime 33 (38%), flucloxacillin 24 (28.6%), and ampicillin 13 (15.5%). Penicillin 4 (4.8%) and tetracycline 6 (7.1%) were the least susceptible. The findings from this study emphasize the need for continual surveillance of MRSA and of antibiotic resistance in general. more...
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- 2012
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7. Bloodstream Infections at Two Neonatal Intensive Care Units in Ghana
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Appiah-Korang Labi, Leif P. Andersen, Stephanie Bjerrum, Jørgen A. L. Kurtzhals, Edmund T. Nartey, Mercy J. Newman, Christabel Enweronu-Laryea, and Prosper K Ayibor
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Male ,Microbiology (medical) ,medicine.medical_specialty ,Ghana ,Antibiotic resistance ,Enterobacteriaceae ,Drug Resistance, Multiple, Bacterial ,Intensive Care Units, Neonatal ,Sepsis ,Internal medicine ,Intensive care ,medicine ,Humans ,Blood culture ,Prospective Studies ,Cross Infection ,medicine.diagnostic_test ,business.industry ,Incidence ,Incidence (epidemiology) ,Mortality rate ,Hazard ratio ,Enterobacteriaceae Infections ,Infant, Newborn ,Anti-Bacterial Agents ,Infectious Diseases ,Amikacin ,Pediatrics, Perinatology and Child Health ,Female ,Gentamicin ,business ,medicine.drug - Abstract
Background Bloodstream infections (BSIs) are a major cause of morbidity and mortality in hospitalized neonates. Data on antibiotic resistance in neonatal BSIs and their impact on clinical outcomes in Africa are limited. Methods We conducted a prospective cohort study at 2 tertiary level neonatal intensive care units (NICUs) in Ghana. All neonates admitted to the NICUs were included from October 2017 to September 2019. We monitored BSI rates and analyzed the effect of BSI and antibiotic resistance on mortality and duration of hospitalization. Results Out of 5433 neonates included, 3514 had at least one blood culture performed and 355 had growth of a total of 368 pathogenic microorganisms. Overall incidence of BSI was 1.0 (0.9-1.1) per 100 person days. The predominant organisms were Klebsiella pneumoniae 49.7% (183/368) and Streptococcus spp. 10.6% (39/368). In addition, 512 coagulase negative Staphylococci were isolated but considered probable contaminants. Among K. pneumoniae, resistance to gentamicin and amikacin was 91.8% and 16.4%, respectively, while carbapenem resistance was 4.4%. All-cause mortality among enrolled neonates was 19.7% (1066/5416). The mortality rate was significantly higher in neonates with BSI compared with culture-negative neonates in univariate analysis (27.9%, n = 99/355 vs. 16.5%, n = 520/3148; hazard ratio 1.4, 95% confidence interval 1.07-1.70) but not in multivariate analysis. Conclusion The diversity of etiological agents and the high risk of antibiotic resistance suggest that standard empirical treatment is unlikely to improve the outcome of BSIs in low and middle income. Such improvements will depend on access to reliable clinical microbiologic services. more...
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- 2021
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8. Microscopic Observation Drug Susceptibility (MODS) Assay: A Convenient Method for Determining Antibiogram of Clinical Isolates of Mycobacterium tuberculosis in Ghana
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Mercy J. Newman and Enid Owusu
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0301 basic medicine ,medicine.medical_specialty ,Tuberculosis ,030106 microbiology ,lcsh:Medicine ,MODS ,Article ,susceptibility ,Mycobacterium tuberculosis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,030212 general & internal medicine ,Ethambutol ,biology ,business.industry ,lcsh:R ,Isoniazid ,Drug susceptibility ,Pyrazinamide ,biology.organism_classification ,medicine.disease ,tuberculosis ,Streptomycin ,business ,Rifampicin ,medicine.drug - Abstract
(1) Background: Present methods for drug susceptibility tests (DST) rely on culture methods that are sophisticated and relatively faster, or a slow and cheaper option. These methods frustrate disease control, therefore, there is a need for methods that incorporate key functions of microscopy and culture, with reduced cost burden and sophistry. Thus, the purpose of this study was to identify which, among the most commonly used (in Ghana) methods, can conveniently be used at health centers located in rural areas for effective DST determination of Mycobacterium tuberculosis (MTB). (2) Methods: Mycobacterium tuberculosis isolates were tested for their susceptibility to streptomycin, isoniazid, rifampicin, ethambutol (SIRE), and pyrazinamide by microscopic observation drug susceptibility (MODS) and BACTEC MGIT 960 methods. Evaluations were based on shorter turnaround periods, rapidity, ease of use, cost, etc. A comparative analysis was statistically expressed as kappa values. (3) Results: Endpoints for drug susceptibilities by MODS averaged 13 days (7&ndash, 32), whilst that for BACTEC MGIT 960 was 10 days with a further 12 days to detect resistance. Therefore, a turnaround period of 22 days was needed for DST by BACTEC MGIT 960, compared to 13 days for MODS. There were differences in correlation levels between the two methods, as determined by their kappa values. (4) Conclusion: The MODS assay was found to be less costly, more user-friendly, and still able to be conveniently used at health centers located in rural areas known to be endemic for TB, particularly in Ghana. more...
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- 2020
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9. Maximizing microscopy as a diagnostic tool in peripheral health centres of BU endemic areas in Ghana
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Mercy J. Newman, Gerd Pluschke, Amos Akumwena, Lawrence Ofosu-Appiah, and Enid Owusu
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DNA, Bacterial ,Microbiology (medical) ,Buruli ulcer ,Bacilli ,Veterinary medicine ,Endemic Diseases ,Acid fast bacilli ,Cost-Benefit Analysis ,lcsh:QR1-502 ,Ghana ,Polymerase Chain Reaction ,lcsh:Microbiology ,Specimen Handling ,Microbiology ,chemistry.chemical_compound ,medicine ,Humans ,Ammonium ,Centrifugation ,Buruli Ulcer ,Bacteriological Techniques ,Microscopy ,Mycobacterium ulcerans ,biology ,business.industry ,Resource constraints ,biology.organism_classification ,medicine.disease ,Infectious Diseases ,chemistry ,Sodium hypochlorite ,Acid-fast ,Rural Health Services ,business - Abstract
BackgroundBuruli ulcer (BU) disease, a skin condition caused by Mycobacterium ulcerans (M. ulcerans) is endemic in remote rural areas. Disease diagnosis on clinical basis alone can be misleading, requiring definitive diagnosis based on laboratory tests. Resource constraints in BU endemic areas make microscopy for the detection of acid fast bacilli (AFB) an important and useful method. It is rapid, user-friendly, convenient and cheap. Despite its usefulness, its performance is relatively low. This study investigated modifications of the current method aimed at improving its performance. Forty (IS) 2404 polymerase chain reactions (PCR) positive BU samples were processed by eight physical (centrifugation and overnight sedimentation) and chemical (phenol ammonium sulphate and sodium hypochlorite) modifications of the current direct method. Assessments were based on standard AFB evaluation coupled with in house criteria; positivity (P), clarity and contrast (C) release of bacilli from specimen (R). Overall AFB positivity rate was 64% (409/640). Each protocol had 80 smears. The percentage positivity (P) for the conventional method was 58% (46/80) smears. The highest positivity rate of 57/80 (%) was by protocol 7 (5% phenol in 4% ammonium sulphate (PhAS) and concentrated by overnight gravitational sedimentation). The least positivity rate at 35% (28/80) was by protocol 1 (smears from direct application of swab tips). The differences in performance between the two chemical tested; 5% phenol in 4% ammonium sulphate (PhAS) and 3.5% NaHOCl was significant (p0.05). This study concluded that BU samples treated with a solution of 5% phenol in 4% ammonium sulphate and concentrated by either centrifugation or overnight sedimentation is useful for maximizing AFB detection by bright field microscopy. This can be useful in rural health facilities with resource constraints. more...
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- 2015
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10. Clonal distribution of pneumococcal serotype 19F isolates from Ghana
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Nicholas T. K. D. Dayie, Niels Frimodt-Møller, Richael O. Mills, Nadja Sparding, Mercy J. Newman, Hans Christian Slotved, and Anders Dalsgaard
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Microbiology (medical) ,Serotype ,Biology ,Serogroup ,medicine.disease_cause ,Ghana ,Microbiology ,Pneumococcal Infections ,law.invention ,law ,Streptococcus pneumoniae ,Genetics ,medicine ,Cluster Analysis ,Humans ,Outpatient clinic ,Typing ,Molecular Biology ,Ecology, Evolution, Behavior and Systematics ,Infant, Newborn ,Infant ,Virology ,Penicillin ,Infectious Diseases ,Carriage ,Gram staining ,Genes, Bacterial ,Child, Preschool ,Multilocus sequence typing ,Multilocus Sequence Typing ,medicine.drug - Abstract
Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide. Pneumococcal strains are classified according to their capsular polysaccharide and more than 90 different serotypes are currently known. In this project, three distinct groups of pneumococcal carriage isolates from Ghana were investigated; isolates from healthy children in Tamale and isolates from both healthy and children attending the outpatient department at a hospital in Accra. The isolates were previously identified and characterized by Gram staining, serotyping and susceptibility to penicillin. In this study, isolates of the common serotype 19F were further investigated by Multi-Locus Sequence Typing (MLST). Overall, 14 different Sequence Types (STs) were identified by MLST, of which nine were novel based on the international MLST database. Two clones within serotype 19F seem to circulate in Ghana, a known ST (ST 4194) and a novel ST (ST 9090). ST 9090 was only found in healthy children in Accra, whereas ST 4194 was found equally in all children studied. In the MLST database, other isolates of ST 4194 were also associated with serotype 19F, and these isolates came from other West African countries. The majority of isolates were penicillin intermediate resistant. In conclusion, two clones within serotype 19F were found to be dominating in pneumococcal carriage in Accra and Tamale in Ghana. Furthermore, it seems as though the clonal distribution of serotype 19F may be different from what is currently known in Ghana in that many new clones were identified. This supports the importance of continued monitoring of pneumococcal carriage in Ghana and elsewhere when vaccines, e.g., PCV-13, have been introduced to monitor the possible future spread of antimicrobial resistant clones. more...
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- 2015
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11. Prevalence of antimicrobial resistant pathogens from blood cultures: results from a laboratory based nationwide surveillance in Ghana
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Japheth A. Opintan and Mercy J. Newman
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Antimicrobial drug resistance ,0301 basic medicine ,Microbiology (medical) ,030106 microbiology ,Population ,Drug resistance ,medicine.disease_cause ,Blood culture ,lcsh:Infectious and parasitic diseases ,Microbiology ,03 medical and health sciences ,Medicine ,lcsh:RC109-216 ,Pharmacology (medical) ,Cefoxitin ,education ,education.field_of_study ,Surveillance ,medicine.diagnostic_test ,business.industry ,Pseudomonas aeruginosa ,Research ,Public Health, Environmental and Occupational Health ,Methicillin resistance ,Multiple drug resistance ,Infectious Diseases ,Staphylococcus aureus ,Bloodstream infections ,Coagulase ,business ,medicine.drug - Abstract
Background Blood stream infections (BSI) are critical medical conditions with high morbidity and mortality. There is paucity of information on BSI from surveillance studies in Ghana. Aim This study sought to demonstrate how useful BSI data can be gleaned from population-based surveillance, especially from resource-limited settings. Methods Data from a nationwide surveillance of antimicrobial drug resistance (AMR) in Ghana were extracted and analyzed. Secondly, we revived archived Staphylococcus aureus isolates from blood cultures that were cefoxitin resistant (CRSA), and screened these for protein A (spa) and mec A genes. Results Overall blood culture positivity was 11.2% (714/6351). All together, participating laboratories submitted 100 multidrug resistant blood culture isolates (Gram-negative = 49 and Gram-positive = 51). Prevalence of some Gram-negative isolates was as follows; Escherichia coli (20.4%), Pseudomonas aeruginosa (16.3%), Enterobacter spp. (14.3%), Salmonella serotype Typhi (8.2%) and Non-typhoidal Salmonella [NTS] (8.2%). Gram-positive pathogens included Staphylococcus aureus (66.7%), coagulase negative S. aureus [CoNS] (17.6%) and Streptococcus pneumoniae (11.8%). No methicillin resistance was confirmed in our CRSA isolates. Most blood stream associated infections were from inpatients (75%) and cultured bacteria were resistant to common and cheaper antimicrobials. Conclusion E. coli and S. aureus are common pathogens associated with BSI in Ghana and they are resistant to several antimicrobials. Active and continuous AMR surveillance can serve multiple purposes, including data generation for BSI. more...
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- 2017
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12. Microbiological quality of packaged water sold in Accra, Ghana
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Mercy J. Newman, Abena Safoa Osei, J. A. A. Mingle, Mubarak Osei Kwasi, and Patrick F. Ayeh-Kumi
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Toxicology ,Tap water ,business.industry ,Environmental protection ,Medicine ,Microbiological quality ,Bottled water ,business ,Food Science ,Biotechnology - Abstract
Consumers perceive packaged drinking water, usually distributed as bottled or in polyethylene packages (sachets), as healthier and safer alternatives to tap water. The objective of this study was to determine the microbiological quality of different types of packaged drinking water available in Accra, Ghana. Sixty samples of sachet water and ten of (PET) bottled water were randomly purchased from various locations in Accra. Bacteriological and parasitological analyses of the packaged (sachet and bottled) and tap water (as control) were done according to standard procedures. Fifty-two out of 60 sachet water samples (86.7%) had HPC levels well above the internationally recommended limits. For the bottled water, nine out of the ten (90%) were within the recommended limits for HPC. Two out of the five (40%) tap water samples (control samples) had HPC above the recommended limits of 500 cfu/mL. While none of the bottled water samples showed the presence of protozoa, two out of the five tap water and 31 out of the 60 sachet water samples had a wide range of protozoa including rotifers. The findings clearly indicate that while PET bottled water sold in Accra may be generally safe, the same cannot be said for the sachet water; since the study found its microbiological quality not significantly different from tap water. more...
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- 2013
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13. High Levels of Extended-Spectrum Beta-Lactamases in a Major Teaching Hospital in Ghana: The Need for Regular Monitoring and Evaluation of Antibiotic Resistance
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Karen A. Krogfelt, Noah Obeng-Nkrumah, Mercy J. Newman, and Kingsley Twum-Danso
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Male ,Antibiotics ,Gene Expression ,Ghana ,polycyclic compounds ,Child ,Aged, 80 and over ,Sulfonamides ,biology ,Enterobacteriaceae Infections ,Articles ,Middle Aged ,Anti-Bacterial Agents ,Infectious Diseases ,Child, Preschool ,Epidemiological Monitoring ,Female ,Fluoroquinolones ,Adult ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,beta-Lactam Resistance ,beta-Lactamases ,Teaching hospital ,Microbiology ,Antibiotic resistance ,Enterobacteriaceae ,Virology ,Internal medicine ,medicine ,Humans ,Hospitals, Teaching ,Aged ,Adult patients ,business.industry ,Infant, Newborn ,Infant ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,bacterial infections and mycoses ,Confidence interval ,Multiple drug resistance ,Aminoglycosides ,Carbapenems ,Relative risk ,bacteria ,Parasitology ,business ,Bacteria - Abstract
Infections with bacteria producing extended-spectrum beta-lactamases (ESBLs) are increasing across Africa. This study reports on ESBL-producing Enterobacteriaceae as significant causes of infections and antibiotic resistance at Korle-Bu Teaching Hospital in Accra, Ghana. Of 300 isolates examined, 49.3% produced ESBLs. The prevalence of ESBLs was significantly high among isolates from neonates (28 of 43, 65.1%; relative risk = 1.62, 95% confidence interval = 1.33-2.13, P = 0.002) and adult patients > 65 years of age (36 of 51, 70.5%; relative risk = 1.89, 95% confidence interval = 1.41-2.40, P = 0.001). A marked increase in minimum inhibitory concentrations of ESBL-positive species was noticed compared with those for the other strains. Using these concentrations, we found that 26 (17%) ESBL producers were resistant to two or more antibiotics (aminoglycosides, fluoroquinolones, sulfonamide, and carbapenems) whereas 5 (3.2%) non-ESBL producers were multidrug resistant. Regular ESBL detection and evaluation of antibiotic resistance may help reduce the spread of ESBLs and antibiotic resistance in Ghana. more...
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- 2013
14. Epidemiological aspects of non-human antibiotic usage and resistance: implications for the control of antibiotic resistance in Ghana
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Mercy J. Newman, Eric S. Donkor, and Dorothy Yeboah-Manu
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Gynecology ,medicine.medical_specialty ,Infectious Diseases ,Antibiotic resistance ,medicine.drug_class ,Antibiotics ,Public Health, Environmental and Occupational Health ,medicine ,Parasitology ,Drug resistance ,Biology - Abstract
Objectives To provide insights into the epidemiology of antibiotic usage in animal husbandry in Ghana and its effect on resistance. Methods Three hundred and ninety-five randomly sampled commercial livestock keepers who practised intensive or extensive farming were interviewed about their antibiotic usage practices using a structured questionnaire. Escherichia coli isolated from stool specimens of farmers and their animals were tested against eight antibiotics using the Kirby Bauer method. Results Ninety-eight percent (387) of the farmers used antibiotics on animals and the main purpose was to prevent infections in animals; 41% applied antibiotics monthly. The overall prevalence of multiple drug resistance among the E. coli isolates was 91.6%; rates in human and animal isolates were 70.6% and 97.7%, respectively. The prevalence of resistance in animal isolates to the various drugs ranged from 60.8% (amikacin) to 95.7% (ampicillin); the prevalence of resistance in human isolates to the drugs ranged from 2% (cefuroxime) to 94.1% (gentamicin). Animal E. coli isolates showed higher resistance than that of human isolates for five of eight drugs tested. Conclusion It is concluded that antibiotic usage in animal husbandry in Ghana is more driven by the interest of livestock keepers to prevent and treat animal infections than growth enhancement. Both animal and human E. coli showed high levels of antibiotic resistance, although resistance of animal isolates appeared to be higher than that of humans. There is the need for the development of an antibiotic-resistance management programme in Ghana that will focus simultaneously on human and animal use of antibiotics. Objectifs: Fournir un apercu de l’epidemiologie de l’utilisation des antibiotiques dans l’elevage des animaux au Ghana et son effet sur la resistance. Methodes: Un echantillon aleatoirement de 395 eleveurs commerciaux qui pratiquaient une agriculture intensive ou extensive ont ete interroges sur leurs pratiques d’utilisation des antibiotiques a l’aide d’un questionnaire structure. Des isolats d’E. coli obtenus a partir d’echantillons de selles des eleveurs et de leurs animaux ont ete testes contre 8 antibiotiques en utilisant la methode Kirby Bauer. Resultats: 98% (387) des agriculteurs utilisaient des antibiotiques pour prevenir les infections chez les animaux; 41% appliquaient des antibiotiques mensuellement. La prevalence globale de la resistance multiple aux medicaments parmi les isolats d’E. colietait de 91,6%, les taux parmi les isolats humains et animaux etaient de 70,6% et 97,7% respectivement. La prevalence de la resistance parmi les isolats animaux pour les differents medicaments variait de 60,8% (amikacine) a 95,7% (ampicilline). La prevalence de la resistance aux medicaments parmi les isolats humains variait de 2% (cefuroxime) a 94,1% (gentamicine). Les isolats animaux d’E. coli montraient une plus grande resistance que les isolats humains pour 5 des 8 medicaments testes. Conclusion: Il a ete conclu que l’utilisation des antibiotiques dans l’elevage au Ghana est plus guidee par l’interet des eleveurs a prevenir et traiter les infections des animaux que pour l’amelioration de la croissance. Les isolats animaux et humains d’E. coli ont tous revele des niveaux eleves de resistance aux antibiotiques, quoique la resistance des isolats animaux semblent etre plus elevee que celles des isolats humains. Il est necessaire de developper un programme de gestion de la resistance aux antibiotiques au Ghana, qui portera simultanement sur l’utilisation humaine et animale des antibiotiques. Objetivos: Aportar informacion sobre la epidemiologia del uso de antibioticos en la cria de animales en Ghana y sus efectos sobre la resistencia a los mismos. Metodos: Se entrevistaron 395 granjeros comerciales que practicaban ganaderia intensiva o extensiva, y mediante un cuestionario estructurado se les pregunto acerca de sus practicas en el uso de antibioticos. A las cepas de E. coli aisladas de las muestras de heces de los ganaderos y sus animales se les realizo una prueba de susceptibilidad frente a 8 antibioticos mediante el metodo de Kirby Bauer. Resultados: Un 98% (387) de los ganaderos daba antibioticos a sus animales para prevenir infecciones; y un 41% aplicaba los antibioticos mensualmente. La prevalencia general de resistencia multiple entre las cepas de E. coli era del 91.6%; las tasas en cepas aisladas de hombres y animales eran del 70.6% y 97.7% respectivamente. La prevalencia de resistencia en cepas aisladas de animales a los diferentes antibioticos testados estaban en un rango de 60.8% (amikacina) a 95.7% (ampicilina); la prevalencia de resistencias a los antibioticos en aislados provenientes de humanos estaban en un rango del 2% (cefuroxima) al 94.1% (gentamicina). Las cepas de E. coli aisladas de animales, mostraban una mayor resistencia que las aisladas de humanos, para 5 de los 8 antimicrobianos evaluados. Conclusion: En Ghana, el uso de antibioticos en ganaderia se debe principalmente al interes de los ganaderos de prevenir y tratar las infecciones de los animales, mas que en inducir una mejora en el crecimiento y el engorde. Las cepas aisladas de E. coli, tanto de humanos como de animales, mostraron altos niveles de resistencia a los antibioticos, aunque la resistencia de las cepas aisladas de animales parecia ser mayor que la de cepas aisladas de humanos. En Ghana es necesario desarrollar un programa para el manejo de las resistencias a los antibioticos, que se centre simultaneamente en el uso de antibioticos tanto en animales como en humanos. more...
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- 2012
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15. Investigation into the risk of exposure to antibiotic residues contaminating meat and egg in Ghana
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Sammy C. K. Tay, Nicholas T. K. D. Dayie, Michael Olu-Taiwo, Eric S. Donkor, Mercy J. Newman, and Elizabeth Bannerman
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High rate ,Antibiotic drug ,Related factors ,Drug ,business.industry ,medicine.drug_class ,media_common.quotation_subject ,digestive, oral, and skin physiology ,Antibiotics ,Prevalence ,Biology ,Food safety ,Biotechnology ,Toxicology ,Animal source foods ,medicine ,business ,Food Science ,media_common - Abstract
In Ghana and many developing countries, little is known about food safety in relation to antibiotic residues. The objectives of the study were to (i) determine the prevalence of antibiotic residues in animal source food and estimate the risk to consumers (ii) identify factors predisposing animal source food to contamination with antibiotic drug residues. A total of 634 samples of various animal source foods, including beef, chevon, mutton, pork and egg were screened for drug residues. Additionally, epidemiological data related to antibiotic usage on animals and consumption patterns of animal source food was collected from animal farmers and consumers of animal source food respectively. Overall, the prevalence of drug residues in animal source food was 21.1%, which translates to an average risk of exposure every fifth time animal source food is consumed. The prevalence rates of drug residues in the various animal source foods were; 30.8% (beef); 29.3% (chevon); 28.6% (pork); 24% (mutton); and 6.8% (egg). The trends of consumption of the animal source foods were similar, and majority of the consumers consumed the food every week. Considering the relatively high contamination rates of animal source food as well as their high rates of consumption, it is likely that consumers experience a high risk of exposure to drug residues, especially through beef. Specific causal factors associated with non-adherence of withdrawal requirements of drugs, and therefore contaminations of food were mainly knowledge related factors. This underscores the importance of health education of farmers in dealing with the problem of drug residues contaminating animal source food. more...
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- 2011
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16. Invasive disease and paediatric carriage of Streptococcus pneumoniae in Ghana
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Mercy J. Newman, Nicholas T. K. D. Dayie, Joseph Oliver-Commey, Eric S. Donkor, Ebenezer V Badoe, and Elizabeth Bannerman
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Adult ,Microbiology (medical) ,Serotype ,Adolescent ,Antibiotic sensitivity ,Microbial Sensitivity Tests ,Drug resistance ,Biology ,medicine.disease_cause ,Ghana ,Pneumococcal Infections ,Pneumococcal conjugate vaccine ,Microbiology ,Pneumococcal Vaccines ,Young Adult ,Drug Resistance, Multiple, Bacterial ,Nasopharynx ,Streptococcus pneumoniae ,Prevalence ,medicine ,Humans ,Serotyping ,Child ,Aged ,Cerebrospinal Fluid ,General Immunology and Microbiology ,Neisseria meningitidis ,Infant, Newborn ,Infant ,Sequence Analysis, DNA ,General Medicine ,Middle Aged ,medicine.disease ,DNA Fingerprinting ,Virology ,Bacterial Typing Techniques ,Pneumococcal infections ,Infectious Diseases ,Child, Preschool ,Carrier State ,Multilocus sequence typing ,medicine.drug - Abstract
This study was carried out primarily to evaluate the public health burden related to Streptococcus pneumoniae in Ghana and to provide related preliminary molecular epidemiological data on the organism. Invasive and nasopharyngeal specimens were screened for S. pneumoniae, and isolates were subjected to serotyping, multilocus sequence typing (MLST) and antibiotic susceptibility testing. Overall, the prevalence of S. pneumoniae in cerebrospinal fluid (CSF) was 1.7%, in blood was 0.2%, and in nasopharyngeal specimens was 15.3%. The prevalence of multiple drug resistance among the isolates was 48.6%, while the percentage resistance to various drugs was in the range of 11.1-84.0%. Serotyping of the S. pneumoniae isolates showed 7 different serotypes (3, 6B, 9, 10, 14, 16 and 23F). The extent of coverage of serotypes by the 7-valent pneumococcal conjugate vaccine was 57.1%, for the 10-valent vaccine was 57.1%, and for the 13-valent vaccine was 71.4%. MLST of 7 housekeeping genes of the organism showed a high level of genetic diversity among the isolates. S. pneumoniae appears to be an important organism in invasive infections in Ghana, being the most prevalent organism in CSF in this study. The high multiple drug resistance of the organism observed heightens the public health burden, which may be controlled by pneumococcal conjugate vaccines to a large extent. more...
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- 2010
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17. Carriage of diarrhoeagenic Escherichia coli by older children and adults in Accra, Ghana
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Japheth A. Opintan, Iruka N. Okeke, Mercy J. Newman, and Rima A. Bishar
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Adult ,Diarrhea ,Male ,medicine.medical_specialty ,Adolescent ,Pilot Projects ,Biology ,medicine.disease_cause ,Ghana ,Asymptomatic ,Feces ,Enterotoxigenic Escherichia coli ,Internal medicine ,parasitic diseases ,Escherichia coli ,Prevalence ,medicine ,Humans ,Diffusely Adherent Escherichia coli ,Enteropathogenic Escherichia coli ,Child ,Escherichia coli Infections ,Public Health, Environmental and Occupational Health ,Infant ,General Medicine ,Infectious Diseases ,Carriage ,Enteroaggregative Escherichia coli ,Immunology ,Female ,Parasitology ,medicine.symptom - Abstract
Diarrhoeagenic Escherichia coli (DEC) were sought in stool specimens from 72 adults and children aged over 3 years, who presented with diarrhoea at a hospital in Accra, Ghana, and 72 matched controls. Only diffusely-adherent E. coli were significantly associated with disease in these older individuals (P=0.029). We additionally tested 53 specimens from infants among whom DEC were collectively associated with disease (P=0.012). Enteropathogenic, enterotoxigenic and enteroaggregative E. coli, the most commonly isolated pathotypes from infants with diarrhoea, were frequently recovered from healthy adults. Asymptomatic carriage of DEC by older individuals in Accra may place young children at risk for diarrhoea. more...
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- 2010
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18. INTRODUCTION OF HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE VACCINE INTO ROUTINE IMMUNIZATION IN GHANA AND ITS IMPACT ON BACTERIAL MENINGITIS IN CHILDREN YOUNGER THAN FIVE YEARS
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Mercy J. Newman, Kwadwo Odei Antwi-Agyei, Lorna Renner, Lawson Ahadzie, and Messeret Eshetu
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Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,Neisseria meningitidis ,medicine.disease_cause ,Ghana ,Meningitis, Bacterial ,Haemophilus influenzae ,Pentavalent vaccine ,Conjugate vaccine ,Humans ,Medicine ,Meningitis, Haemophilus ,Haemophilus Vaccines ,Vaccines, Conjugate ,Immunization Programs ,business.industry ,Polyvalent Vaccine ,Incidence ,Incidence (epidemiology) ,Haemophilus influenzae type b ,Infant ,medicine.disease ,Vaccination ,Streptococcus pneumoniae ,Infectious Diseases ,Immunization ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Immunology ,business ,Meningitis - Abstract
This report shows the impact of a pentavalent vaccine that includes Haemophilus influenzae type b (Hib) conjugate vaccine on bacterial meningitis in children younger than 5 years in Ghana. A review of the first 3 years of a pediatric bacterial meningitis surveillance program, started in August 2001 in Accra, Ghana, was undertaken. There was a significant reduction, P = 0.042 and 0.017, in percentage of purulent meningitis in children younger than 1 year, comparing the first year when the vaccine was introduced, to the second and third years, respectively. more...
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- 2007
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19. Epidemiological aspects of non-human antibiotic usage and resistance: implications for the control of antibiotic resistance in Ghana
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Eric S, Donkor, Mercy J, Newman, and Dorothy, Yeboah-Manu
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Infection Control ,Microbial Sensitivity Tests ,Ghana ,Drug Utilization ,Anti-Bacterial Agents ,Feces ,Risk Factors ,Drug Resistance, Bacterial ,Escherichia coli ,Prevalence ,Animals ,Humans ,Animal Husbandry ,Escherichia coli Infections ,Environmental Monitoring - Abstract
To provide insights into the epidemiology of antibiotic usage in animal husbandry in Ghana and its effect on resistance.Three hundred and ninety-five randomly sampled commercial livestock keepers who practised intensive or extensive farming were interviewed about their antibiotic usage practices using a structured questionnaire. Escherichia coli isolated from stool specimens of farmers and their animals were tested against eight antibiotics using the Kirby Bauer method.Ninety-eight percent (387) of the farmers used antibiotics on animals and the main purpose was to prevent infections in animals; 41% applied antibiotics monthly. The overall prevalence of multiple drug resistance among the E. coli isolates was 91.6%; rates in human and animal isolates were 70.6% and 97.7%, respectively. The prevalence of resistance in animal isolates to the various drugs ranged from 60.8% (amikacin) to 95.7% (ampicillin); the prevalence of resistance in human isolates to the drugs ranged from 2% (cefuroxime) to 94.1% (gentamicin). Animal E. coli isolates showed higher resistance than that of human isolates for five of eight drugs tested.It is concluded that antibiotic usage in animal husbandry in Ghana is more driven by the interest of livestock keepers to prevent and treat animal infections than growth enhancement. Both animal and human E. coli showed high levels of antibiotic resistance, although resistance of animal isolates appeared to be higher than that of humans. There is the need for the development of an antibiotic-resistance management programme in Ghana that will focus simultaneously on human and animal use of antibiotics. more...
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- 2012
20. Prevalence and associated risk factors of asymptomatic bacteriuria in ante-natal clients in a large teaching hospital in Ghana
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GY Ganyaglo, Mercy J. Newman, Appiah Korang Labi, and Alfred Yawson
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Adult ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Bacteriuria ,Cross-sectional study ,Prevalence ,Microbial Sensitivity Tests ,Prenatal care ,urologic and male genital diseases ,Ghana ,Asymptomatic ,Young Adult ,Pregnancy ,Risk Factors ,medicine ,Humans ,Pregnancy Complications, Infectious ,Hospitals, Teaching ,Asymptomatic Infections ,Original Research ,Gynecology ,business.industry ,Prenatal Care ,General Medicine ,medicine.disease ,female genital diseases and pregnancy complications ,Asymptomatic bacteriuria, ante-natal clients, antibiotic sensitivity, tertiary hospital, Ghana ,Anti-Bacterial Agents ,Cross-Sectional Studies ,Nitrofurantoin ,Marital status ,Female ,medicine.symptom ,business ,Enterococcus ,medicine.drug - Abstract
Introduction : Asymptomatic bacteriuria, the presence of bacteria in urine without symptoms of acute urinary tract infection, predisposes pregnant women to the development of urinary tract infections and pyelonephritis, with an attendant pregnancy related complications. Objective : To measure the prevalence of asymptomatic bacteriuria among ante-natal clients at the Korle-Bu Teaching Hospital in Ghana and its’ associated risk factors. Methods : A cross-sectional study involving 274 antenatal clients was conducted over a period of 4 weeks. A face to face questionnaire was completed and midstream urine collected for culture and antimicrobial susceptibility testing. Results : The prevalence of asymptomatic bacteriuria was 5.5%. It was associated with sexual activity during pregnancy (Fisher’s Exact 5.871, p-value 0.0135), but not with sexual frequency. There were no significant associations with educational status, parity, gestational age, marital status and the number of foetuses carried. The commonest organism isolated was Enterococcus spp (26.7%) although the enterobacteriaceae formed the majority of isolated organisms (46.7%). Nitrofurantoin was the antibiotic with the highest sensitivity to all the isolated organisms. Conclusions : The prevalence of asymptomatic bacteriuria among ante-natal clients at this large teaching hospital in Ghana is 5.5%, which is lower than what has been found in other African settings. Enterococcus spp was the commonest causative organism. However, due to the complications associated with asymptomatic bacteriuria, a policy to screen and treat- all pregnant women attending the hospital, is worth considering. Key words: Asymptomatic bacteriuria, ante-natal clients, antibiotic sensitivity, tertiary hospital, Ghana more...
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- 2015
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21. Salmonella bloodstream infection in Ghanaian children
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Mercy J. Newman, Julia Wilkens, Joseph Oliver Commey, and Harald Seifert
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Microbiology (medical) ,Abdominal pain ,Salmonella ,clinical features ,medicine.diagnostic_test ,medicine.drug_class ,Antibiotics ,General Medicine ,Jaundice ,Biology ,medicine.disease_cause ,Microbiology ,Antibiotic resistance ,Infectious Diseases ,Non-typhoidal salmonella bloodstream infection ,Bloodstream infection ,medicine ,risk factors ,Blood culture ,multiple antibiotic resistance ,medicine.symptom ,Pathogen - Abstract
Objective To examine the frequency of community-acquired salmonella bloodstream infection in Ghanaian children and the occurrence of antibiotic resistance in salmonellae. Methods The study comprised 472 patients with a blood culture obtained within 48 h of admission to the pediatric department of Korle Bu Teaching Hospital in Accra, Ghana, over a 3-month period. All Salmonella isolates from blood cultures were speciated and antibiotic susceptibility tests were performed. Clinical data of children with salmonella bloodstream infection were compared to those of controls. Two control groups were identified: all children enrolled in the study without salmonella bloodstream infection (group 1), and those with bloodstream infection due to other organisms (group 2). Results A pathogen was isolated from 111 children (23.5%), and salmonellae were among the most common isolates ( n =24; 21.6%). Among Salmonella strains, S. enteritidis ( n = 14; 59%) predominated over S. typhi ( n =6; 25%). Resistance to several antibiotics was only found in S. enteritidis isolates ( n =8; 57%). Children with salmonella bloodstream infection presented more often than controls with severe anemia, jaundice, abdominal pain and distension as well as hepatomegaly and splenomegaly. They were also hospitalized for a significantly longer period, but the case-fatality rate was similar. Conclusions Salmonella bloodstream infection, especially due to non-typhoidal strains, is a potential health problem for Ghanaian children and may be complicated by resistance to the commonly available antibiotics. more...
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22. Antimicrobial resistance (AMR) and molecular characterization of Neisseria gonorrhoeae in Ghana, 2012-2015.
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Naiki Attram, Bright Agbodzi, Helena Dela, Eric Behene, Edward O Nyarko, Nicholas N A Kyei, John A Larbi, Bernard W L Lawson, Kennedy K Addo, Mercy J Newman, Christopher A Duplessis, Nehkonti Adams, Magnus Unemo, and Andrew G Letizia more...
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Medicine ,Science - Abstract
Neisseria gonorrhoeae antimicrobial resistance (AMR) surveillance is essential for tracking the emergence and spread of AMR strains in local, national and international populations. This is crucial for developing or refining treatment guidelines. N. gonorrhoeae multiantigen sequence typing (NG-MAST) is beneficial for describing the molecular epidemiology of gonococci at national and international levels. Elucidation of AMR determinants to β-lactam drugs, is a means of monitoring the development of resistance. In Ghana, little is known about the current gonococcal AMR prevalence and no characterization of gonococcal isolates has been previously performed. In this study, gonococcal isolates (n = 44) collected from five health facilities in Ghana from 2012 to 2015, were examined using AMR testing, NG-MAST and sequencing of penA. High rates of resistance were identified to tetracycline (100%), benzylpenicillin (90.9%), and ciprofloxacin (81.8%). One isolate had a high cefixime MIC (0.75 μg/ml). Twenty-eight NG-MAST sequence types (STs) were identified, seventeen of which were novel. The isolate with the high cefixime MIC contained a mosaic penA-34 allele and belonged to NG-MAST ST1407, an internationally spreading multidrug-resistant clone that has accounted for most cefixime resistance in many countries. In conclusion, AMR testing, NG-MAST, and sequencing of the AMR determinant penA, revealed high rates of resistance to tetracycline, benzylpenicillin, and ciprofloxacin; as well as a highly diverse population of N. gonorrhoeae in Ghana. It is imperative to continue with enhanced AMR surveillance and to understand the molecular epidemiology of gonococcal strains circulating in Ghana and other African countries. more...
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- 2019
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23. Regional dissemination of a trimethoprim-resistance gene cassette via a successful transposable element.
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Amy S Labar, Jennifer S Millman, Ellen Ruebush, Japheth A Opintan, Rima A Bishar, A Oladipo Aboderin, Mercy J Newman, Adebayo Lamikanra, and Iruka N Okeke
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Medicine ,Science - Abstract
Antimicrobial resistance is a growing international problem. We observed a 50% increase in the prevalence of trimethoprim resistance among fecal Escherichia coli from healthy Nigerian students between 1998 and 2005, a trend to increase that continued in 2009.A PCR-based screen revealed that 131 (43.1%) of isolates obtained in Nigeria in 2005 and 2009 carried integron-borne dfrA cassettes. In the case of 67 (51.1%) of these isolates, the cassette was a class 1-integron-borne dfrA7 gene, which has been reported at high prevalence from E. coli isolates from other parts of Africa. Complete sequencing of a 27 Kb dfrA7-bearing plasmid from one isolate located the dfrA7 gene within a Tn21-type transposon. The transposon also contained an IS26-derived bla/sul/str element, encoding resistance to β-lactams, sulphonamides and streptomycin, and mercury resistance genes. Although the plasmid backbone was only found in 12 (5.8%) of trimethoprim-resistant isolates, dfrA7 and other transposon-borne genes were detected in 14 (16.3%) and 32 (26.3%) of trimethoprim resistant isolates collected in Nigeria in 2005 and 2009, respectively. Additionally, 37 (19.3%) of trimethoprim-resistant E. coli isolates collected between 2006 and 2008 from Ghana were positive for the dfrA7 and a transposon marker, but only 4 (2.1%) harbored the plasmid backbone.Our data point to transposition as a principal mechanism for disseminating dfrA7 among E. coli from Nigeria and Ghana. On-going intensive use of the affordable broad-spectrum antibacterials is likely to promote selective success of a highly prevalent transposable element in West Africa. more...
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- 2012
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