Extended-spectrum beta-lactamases in clinical isolates of Escherichia coli and Klebsiella pneumoniae recovered from patients at the Tamale Teaching Hospital, Ghana

Francis Kwame Morgan Tetteh; Anthony Ablordey; Noah Obeng-Nkrumah; Japheth Awuletey Opintan

doi:10.1371/journal.pone.0300596

Extended-spectrum beta-lactamases in clinical isolates of Escherichia coli and Klebsiella pneumoniae recovered from patients at the Tamale Teaching Hospital, Ghana

PLoS One. 2024 Apr 5;19(4):e0300596. doi: 10.1371/journal.pone.0300596. eCollection 2024.

Authors

Francis Kwame Morgan Tetteh^{1

2}, Anthony Ablordey³, Noah Obeng-Nkrumah¹, Japheth Awuletey Opintan¹

Affiliations

¹ Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.
² Pathology Division, 37 Military Hospital, Accra, Ghana.
³ Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.

Abstract

Introduction: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae are pathogens of significant public health interest for which new antibiotics are urgently needed.

Aim: To determine the prevalence of ESBLs in E. coli and K. pneumoniae isolates from patients attending the Tamale Teaching Hospital (TTH) in Ghana.

Methodology: The study was a cross-sectional study involving convenience sampling of E. coli and K. pneumoniae isolates from consenting patients' clinical specimens, between April and June 2015. Antimicrobial susceptibility test was performed, and ESBL-producer phenotypes were further screened for BlaTEM, BlaSHV, and BlaCTX-M genes. Patients' clinical data were additionally collected using a structured questionnaire.

Results: Of the 150 non-duplicate E. coli and K. pneumoniae isolates identified, 140 were confirmed as E. coli (84%, n = 117) and K. pneumoniae (16%, n = 23). Of these, sixty-two (44%) [E. coli (84%; n = 52); K. pneumoniae (16%; n = 10)] phenotypically expressed ESBLs. The proportion of ESBL-producing isolates was higher in adults (15-65 years) than in neonates (< 28 days) (p = 0.14). Most of the isolates showed a high percentage resistance to ampicillin (96%) and tetracycline (89%), but a relatively lower resistance to amikacin (36%). No isolate was resistant to meropenem. More ESBL producers were multidrug resistant compared to non-ESBL-producers [23% (14/62) versus 18% (14/78); p = 0.573]. Overall, 74% (n = 46) of the ESBL genotypes expressed BlaCTX-M-1 genes, followed by 63% (n = 39) BlaTEM, and 16% (n = 10) BlaSHV. The study showed a high prevalence of ESBL-positive E. coli and K. pneumoniae, mostly CTX-M-1 producers at TTH.

Conclusion: Routine laboratory ESBL screening is warranted to inform patient management.

Copyright: © 2024 Tetteh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adult
Anti-Bacterial Agents / pharmacology
Cross-Sectional Studies
Escherichia coli / genetics
Escherichia coli Infections* / drug therapy
Escherichia coli Infections* / epidemiology
Escherichia coli Infections* / genetics
Ghana / epidemiology
Hospitals, Teaching
Humans
Infant, Newborn
Klebsiella Infections* / drug therapy
Klebsiella Infections* / epidemiology
Klebsiella Infections* / genetics
Klebsiella pneumoniae / genetics
Microbial Sensitivity Tests
beta-Lactamases / genetics

Substances

beta-Lactamases
Anti-Bacterial Agents

Grants and funding

This work was supported with funds from the Bill and Melinda Gates Foundation under the Postdoctoral and Postgraduate Training in Infectious Diseases Research awarded to the Noguchi Memorial Institute for Medical Research (Global Health Grant number OPP52155). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.