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Start Over Author "Opoku-Ware, Ampomah" Topic microbiology
2 results on '"Opoku-Ware, Ampomah"'

1. Klebsiella pneumoniae ST147 harboring blaNDM-1, multidrug resistance and hypervirulence plasmids

Author

Frederick Ofosu-Appiah, Ezra E. Acquah, Jibril Mohammed, Comfort Sakyi Addo, Bright Agbodzi, Dorcas A. S. Ofosu, Charles J. Myers, Quaneeta Mohktar, Opoku-Ware Ampomah, Anthony Ablordey, and Nana Ama Amissah

Subjects
Klebsiella pneumoniae, multidrug resistance, blaNDM-1 gene, hypervirulence, mobile genetic elements, burn wounds, Microbiology, QR1-502
Abstract

ABSTRACTThe spread of hypervirulent (hv) and carbapenem-/multidrug-resistant Klebsiella pneumoniae is an emerging problem in healthcare settings. The New Delhi metallo-β-lactamase-1 (blaNDM-1) is found in Enterobacteriaceae including K. pneumoniae. The blaNDM-1 is capable of hydrolyzing β-lactam antibiotics which are used for treatment of severe infections caused by multidrug-resistant Gram-negative bacteria. This is associated with the unacceptably high mortality rate in immunocompromised burn injury patients. This study reports on the characterization of blaNDM-1 gene and virulence factors in hv carbapenem-/multidrug-resistant K. pneumoniae ST147 in the burns unit of a tertiary teaching hospital during routine surveillance. Two K. pneumoniae strains were obtained from wounds of burn-infected patients from May 2020 to July 2021. The hypervirulence genes and genetic context of the blaNDM-1 gene and mobile genetic elements potentially involved in the transposition of the gene were analyzed. We identified a conserved genetic background and an IS26 and open reading frame flanking the blaNDM-1 gene that could suggest its involvement in the mobilization of the gene. The plasmid harbored additional antibiotic resistance predicted regions that were responsible for resistance to almost all the routinely used antibiotics. To ensure the identification of potential outbreak strains during routine surveillance, investigations on resistance genes and their environment in relation to evolution are necessary for molecular epidemiology.IMPORTANCEData obtained from this study will aid in the prompt identification of disease outbreaks including evolving resistance and virulence of the outbreak bacteria. This will help establish and implement antimicrobial stewardship programs and infection prevention protocols in fragile health systems in countries with limited resources. Integration of molecular surveillance and translation of whole-genome sequencing in routine diagnosis will provide valuable data for control of infection. This study reports for the first time a high-risk clone K. pneumoniae ST147 with hypervirulence and multidrug-resistance features in Ghana.

Published
2024
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2. Epidemiology of Staphylococcus aureus in a burn unit of a tertiary care center in Ghana

Author

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

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