Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

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

Benjamin Asamoah
* ORCID logo ,
Appiah-Korang Labi
,
Himanshu A Gupte
,
Hayk Davtyan
ORCID logo ,
Georgette Marfo Peprah
,
Forster Adu-Gyan
,
Divya Nair
,
Karlos Muradyan
ORCID logo ,
Nasreen S Jessani
,
Paul Sekyere Nyantakyi
Version 1 : Received: 2 November 2022 / Approved: 8 November 2022 / Online: 8 November 2022 (03:25:41 CET)

A peer-reviewed article of this Preprint also exists.

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. 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.

Abstract

Management of urinary tract infection is challenged by increasing antimicrobial re-sistance (AMR) worldwide. In this study we describe the trends in antimicrobial re-sistance 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. 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 car-bapenemase-producing phenotypes were determined. Of 94,134 urine specimens submitted for culture, 20,010 (22.1%) were culture positive. Enterobacterales were the commonest group of organisms, E. coli (70.6) being the commonest isolate and Enterococcus spp. the commonest 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%). Highest multi-drug resistance levels were observed among Klebsiella spp. (68.6%) and E. coli (64.0%). 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 recom-mended antimicrobials

Keywords

Urinary tract infection; Ghana; Antimicrobial resistance (AMR); Multi-drug resistance (MDR); MDS Lancet Laboratories; AWaRE classification; Uropathogens

Subject

Biology and Life Sciences, Immunology and Microbiology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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