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Volume 19
Issue 24
10.3390/ijerph192416556
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Article

High Resistance to Antibiotics Recommended in Standard Treatment Guidelines in Ghana: A Cross-Sectional Study of Antimicrobial Resistance Patterns in Patients with Urinary Tract Infections between 2017–2021

by
Benjamin Asamoah
1,*,
Appiah-Korang Labi
2,
Himanshu A. Gupte
3,
Hayk Davtyan
4,
Georgette Marfo Peprah
1,
Forster Adu-Gyan
1,
Divya Nair
5,
Karlos Muradyan
4,
Nasreen S. Jessani
6,7 and
Paul Sekyere-Nyantakyi
1
1
MDS-Lancet Laboratories, Accra P.O. Box AC 533, Ghana
2
World Health Organization, Country Office, Accra P.O. Box MB 142, Ghana
3
Narotam Sekhsaria Foundation, Mumbai 4000 021, India
4
Tuberculosis Research and Prevention Center, Yerevan 0014, Armenia
5
International Union Against TB and Lung Disease (The Union), 75006 Paris, France
6
Centre for Evidence based Health Care, Department of Global Health, Stellenbosch University, Cape Town 800, South Africa
7
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2022, 19(24), 16556; https://doi.org/10.3390/ijerph192416556
Submission received: 21 September 2022 / Revised: 2 November 2022 / Accepted: 1 December 2022 / Published: 9 December 2022
(This article belongs to the Special Issue Operational Research to Tackle Antimicrobial Resistance in Ghana)
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Abstract

Management of urinary tract infections is challenged by increasing antimicrobial resistance (AMR) worldwide. In this study, we describe the trends in antimicrobial resistance of uropathogens isolated from the largest private sector laboratory in Ghana over a five-year period. We reviewed positive urine cultures at the MDS Lancet Laboratories from 2017 to 2021. The proportions of uropathogens with antimicrobial resistance to oral and parenteral antimicrobials recommended by the Ghana standard treatment guidelines were determined. The proportion of multi-drug resistant isolates, ESBL and carbapenemase-producing phenotypes were determined. Of 94,134 urine specimens submitted for culture, 20,010 (22.1%) were culture positive. Enterobacterales was the most common group of organisms, E. coli (70.6%) being the most common isolate and Enterococcus spp. the most common gram-positive (1.3%) organisms. Among oral antimicrobials, the highest resistance was observed to ciprofloxacin (62.3%) and cefuroxime (60.2%) and the least resistance to fosfomycin (1.9%). The least resistance among parenteral antimicrobials was to meropenem (0.3%). The highest multi-drug resistance levels were observed among Klebsiella spp. (68.6%) and E. coli (64.0%). Extended-spectrum beta-lactamase (ESBL) positivity was highest in Klebsiella spp. (58.6%) and E. coli (50.0%). There may be a need to review the Ghana standard treatment guidelines to reflect increased resistance among uropathogens to recommended antimicrobials.
Keywords: urinary tract infection; Ghana; antimicrobial resistance (AMR); multi-drug resistance (MDR); MDS Lancet Laboratories; Access, Watch and Reserve (AWaRE) classification; uropathogens urinary tract infection; Ghana; antimicrobial resistance (AMR); multi-drug resistance (MDR); MDS Lancet Laboratories; Access, Watch and Reserve (AWaRE) classification; uropathogens

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MDPI and ACS Style

Asamoah, B.; Labi, A.-K.; Gupte, H.A.; Davtyan, H.; Peprah, G.M.; Adu-Gyan, F.; Nair, D.; Muradyan, K.; Jessani, N.S.; Sekyere-Nyantakyi, P. High Resistance to Antibiotics Recommended in Standard Treatment Guidelines in Ghana: A Cross-Sectional Study of Antimicrobial Resistance Patterns in Patients with Urinary Tract Infections between 2017–2021. Int. J. Environ. Res. Public Health 2022, 19, 16556. https://doi.org/10.3390/ijerph192416556

AMA Style

Asamoah B, Labi A-K, Gupte HA, Davtyan H, Peprah GM, Adu-Gyan F, Nair D, Muradyan K, Jessani NS, Sekyere-Nyantakyi P. High Resistance to Antibiotics Recommended in Standard Treatment Guidelines in Ghana: A Cross-Sectional Study of Antimicrobial Resistance Patterns in Patients with Urinary Tract Infections between 2017–2021. International Journal of Environmental Research and Public Health. 2022; 19(24):16556. https://doi.org/10.3390/ijerph192416556

Chicago/Turabian Style

Asamoah, Benjamin, Appiah-Korang Labi, Himanshu A. Gupte, Hayk Davtyan, Georgette Marfo Peprah, Forster Adu-Gyan, Divya Nair, Karlos Muradyan, Nasreen S. Jessani, and Paul Sekyere-Nyantakyi. 2022. "High Resistance to Antibiotics Recommended in Standard Treatment Guidelines in Ghana: A Cross-Sectional Study of Antimicrobial Resistance Patterns in Patients with Urinary Tract Infections between 2017–2021" International Journal of Environmental Research and Public Health 19, no. 24: 16556. https://doi.org/10.3390/ijerph192416556

APA Style

Asamoah, B., Labi, A.-K., Gupte, H. A., Davtyan, H., Peprah, G. M., Adu-Gyan, F., Nair, D., Muradyan, K., Jessani, N. S., & Sekyere-Nyantakyi, P. (2022). High Resistance to Antibiotics Recommended in Standard Treatment Guidelines in Ghana: A Cross-Sectional Study of Antimicrobial Resistance Patterns in Patients with Urinary Tract Infections between 2017–2021. International Journal of Environmental Research and Public Health, 19(24), 16556. https://doi.org/10.3390/ijerph192416556

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