1. Epidemiology of Staphylococcus aureus in a burn unit of a tertiary care center in Ghana
- Author
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Caitlin S. Tetteh, Tjip S. van der Werf, Lieke van Dam, John W. A. Rossen, Anthony Ablordey, Ymkje Stienstra, Opoku-Ware Ampomah, Nana Ama Amissah, Alexander W. Friedrich, Jan Maarten van Dijl, Isaac Prah, Microbes in Health and Disease (MHD), and Translational Immunology Groningen (TRIGR)
- Subjects
0301 basic medicine ,Male ,METHICILLIN-RESISTANT ,Physiology ,Staphylococcus ,Antibiotics ,Burn Units ,lcsh:Medicine ,medicine.disease_cause ,Pathology and Laboratory Medicine ,Ghana ,COLONIZATION ,Geographical Locations ,Tertiary Care Centers ,0302 clinical medicine ,Epidemiology ,Medicine and Health Sciences ,Infection control ,Staphylococcus Aureus ,Hospital Mortality ,lcsh:Science ,Child ,Burn Management ,Cross Infection ,Multidisciplinary ,Transmission (medicine) ,Antimicrobials ,HAND HYGIENE PRACTICES ,Mortality rate ,Drugs ,Staphylococcal Infections ,Bacterial Pathogens ,Body Fluids ,Bacterial Typing Techniques ,PREVALENCE ,PROBABILITY ,Blood ,Staphylococcus aureus ,Medical Microbiology ,INFECTIONS ,Child, Preschool ,Carrier State ,Methicillin-resistant Staphylococcus aureus ,Female ,Pathogens ,Anatomy ,Research Article ,Adult ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Death Rates ,TRANSMISSION ,Health Personnel ,030106 microbiology ,Dermatology ,Microbiology ,03 medical and health sciences ,Young Adult ,Antibiotic resistance ,Microbial Control ,SURVEILLANCE ,medicine ,MANAGEMENT ,Humans ,Intensive care medicine ,Microbial Pathogens ,Demography ,Pharmacology ,Bacteria ,business.industry ,ACQUISITION ,lcsh:R ,Organisms ,Biology and Life Sciences ,030208 emergency & critical care medicine ,Antibiotic Resistance ,People and Places ,Africa ,lcsh:Q ,Antimicrobial Resistance ,business - Abstract
Background: In developing countries, hospitalized burn victims are at high risk of nosocomial infections caused by Staphylococcus aureus. Risk factors include poor infection control practices, prolonged hospitalisation and limited capacity for laboratory microbiological analyses. These problems are compounded by widespread use of antibiotics that drives the spread of multidrug resistant bacteria.Methods: During the study period (November 2014-June 2015), nasal and invasive S. aureus isolates were collected consecutively from patients and healthcare workers (HCWs) within the burn unit of the Reconstructive Plastic Surgery and Burn Center of Korle Bu Teaching Hospital in Ghana. Antibiotic prescription, antibiotic susceptibility and bacterial typing were used to assess antibiotic pressure, antibiotic resistance, and possible transmission events among patients and HCWs.Results: Eighty S. aureus isolates were obtained from 37 of the 62 included burn patients and 13 of the 29 HCWs. At admission, 50% of patients carried or were infected with S. aureus including methicillin resistant S. aureus (MRSA). Antibiotic use per 100 days of hospitalization was high (91.2 days), indicating high selective pressure for resistant pathogens. MRSA isolates obtained from 11 patients and one HCW belonged to the same spa-type t928 and multi-locus sequence type 250, implying possible transmission events. A mortality rate of 24% was recorded over the time of admission in the burn unit.Conclusion: This study revealed a high potential for MRSA outbreaks and emergence of resistant pathogens amongst burn patients due to lack of patient screening and extended empirical use of antibiotics. Our observations underscore the need to implement a system of antibiotic stewardship and infection prevention where microbiological diagnostics results are made available to physicians for timely and appropriate patient treatment.
- Published
- 2017