Nasopharyngeal Carriage and Antimicrobial Resistance Among Adults with Sickle Cell Disease at the Korle Bu Teaching Hospital in Accra, Ghana

Overview

Journal Microbiol Insights

Publisher Sage Publications

Specialty Biology

Date 2022 Nov 7

PMID 36339725

Authors

Nicholas Tkd Dayie

Deborah Nk Sekoh

Patience B Tetteh-Quarcoo

Alberta D Dayie

Mary-Magdalene Osei

Fleischer Cn Kotey

Eric S Donkor

Affiliations

Soon will be listed here.

Abstract

Background: Sickle cell disease (SCD) patients are an important risk group for () carriage and infections. Little is, however, known about the nasopharyngeal carriage epidemiology of the pathogen in this vulnerable population.

Aim: The aim of this study was to evaluate and methicillin-resistant (MRSA) nasopharyngeal carriage prevalence, carriage determinants, and antimicrobial resistance among SCD adults in Ghana.

Methodology: Nasopharyngeal swabs, obtained from 200 SCD adults recruited at the Korle Bu Teaching Hospital, were cultured for , and these isolates were subjected to antimicrobial susceptibility testing via the Kirby-Bauer method.

Results: The prevalence of carriage was 41.5% (n = 83), and that of MRSA carriage was 1.0% (n = 2). Moreover, carriage of coagulase-negative (CoNS) was the only determinant of carriage identified (OR = 0.012, < .0001). However, neither this variable nor the other features of the participants emerged as a determinant of MRSA carriage. The antimicrobial resistance rates decreased across penicillin (98.8%, n = 82), tetracycline (54.2%, n = 45), gentamicin (32.5%, n = 27), ciprofloxacin (21.7%, n = 18), erythromycin (18.1%, n = 15), clindamycin (10.8%, n = 9), amoxicillin-clavulanic acid (10.8%, n = 9), teicoplanin (1.2%, n = 1), and linezolid (0.0%, n = 0), and the multidrug resistance rate was 45.8% (n = 38).

Conclusion: The nasopharyngeal carriage prevalence of in the current study was high, while that of MRSA was low. The isolates were highly resistant to several of the antibiotics tested, but not teicoplanin and linezolid, making these antibiotics suitable for treatment of infections among the SCD population.

Citing Articles

Multidrug-Resistant Gram-Negative Bacteria Contaminating Raw Meat Sold in Accra, Ghana.

Baah D, Kotey F, Dayie N, Codjoe F, Tetteh-Quarcoo P, Donkor E Pathogens. 2022; 11(12).

PMID: 36558851 PMC: 9784824. DOI: 10.3390/pathogens11121517.

References

Shak J, Vidal J, Klugman K . Influence of bacterial interactions on pneumococcal colonization of the nasopharynx. Trends Microbiol. 2013; 21(3):129-35. PMC: 3729046. DOI: 10.1016/j.tim.2012.11.005. View

AkenOva Y, Bakare R, Okunade M . Septicaemia in sickle cell anaemia patients: the Ibadan experience. Cent Afr J Med. 1998; 44(4):102-4. View

Nielsen J, Ladefoged S, Kolmos H . Dialysis catheter-related septicaemia--focus on Staphylococcus aureus septicaemia. Nephrol Dial Transplant. 1998; 13(11):2847-52. DOI: 10.1093/ndt/13.11.2847. View

Hsueh P, Liu C, Luh K . Current status of antimicrobial resistance in Taiwan. Emerg Infect Dis. 2002; 8(2):132-7. PMC: 3369580. DOI: 10.3201/eid0802.010244. View

Dayie N, Sekoh D, Kotey F, Egyir B, Tetteh-Quarcoo P, Adutwum-Ofosu K . Nasopharyngeal Carriage of Methicillin-Resistant (MRSA) among Sickle Cell Disease (SCD) Children in the Pneumococcal Conjugate Vaccine Era. Infect Dis Rep. 2021; 13(1):191-204. PMC: 7931118. DOI: 10.3390/idr13010022. View

Bogaert D, van Belkum A, Sluijter M, Luijendijk A, de Groot R, Rumke H . Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children. Lancet. 2004; 363(9424):1871-2. DOI: 10.1016/S0140-6736(04)16357-5. View

Egyir B, Guardabassi L, Esson J, Nielsen S, Newman M, Addo K . Insights into nasal carriage of Staphylococcus aureus in an urban and a rural community in Ghana. PLoS One. 2014; 9(4):e96119. PMC: 3997564. DOI: 10.1371/journal.pone.0096119. View

VALENTINE F, HALL-SMITH S . Superficial staphylococcal infection. Lancet. 1952; 2(6730):351-4. DOI: 10.1016/s0140-6736(52)92245-9. View

Kluytmans J, van Belkum A, Verbrugh H . Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 1997; 10(3):505-20. PMC: 172932. DOI: 10.1128/CMR.10.3.505. View

10.

Wertheim H, Vos M, Ott A, van Belkum A, Voss A, Kluytmans J . Risk and outcome of nosocomial Staphylococcus aureus bacteraemia in nasal carriers versus non-carriers. Lancet. 2004; 364(9435):703-5. DOI: 10.1016/S0140-6736(04)16897-9. View

11.

Paharik A, Parlet C, Chung N, Todd D, Rodriguez E, Van Dyke M . Coagulase-Negative Staphylococcal Strain Prevents Staphylococcus aureus Colonization and Skin Infection by Blocking Quorum Sensing. Cell Host Microbe. 2017; 22(6):746-756.e5. PMC: 5897044. DOI: 10.1016/j.chom.2017.11.001. View

12.

Akuse R . Variation in the pattern of bacterial infection in patients with sickle cell disease requiring admission. J Trop Pediatr. 1996; 42(6):318-23. DOI: 10.1093/tropej/42.6.318. View

13.

Anafo R, Atiase Y, Kotey F, Dayie N, Tetteh-Quarcoo P, Duodu S . Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage among patients with diabetes at the Korle Bu Teaching Hospital. PLoS One. 2021; 16(9):e0257004. PMC: 8448364. DOI: 10.1371/journal.pone.0257004. View

14.

. Classification of staphylococcal cassette chromosome mec (SCCmec): guidelines for reporting novel SCCmec elements. Antimicrob Agents Chemother. 2009; 53(12):4961-7. PMC: 2786320. DOI: 10.1128/AAC.00579-09. View

15.

Toshkova K, Annemuller C, Akineden O , Lammler C . The significance of nasal carriage of Staphylococcus aureus as risk factor for human skin infections. FEMS Microbiol Lett. 2001; 202(1):17-24. DOI: 10.1111/j.1574-6968.2001.tb10774.x. View

16.

Okuonghae H, Nwankwo M, Offor E . Pattern of bacteraemia in febrile children with sickle cell anaemia. Ann Trop Paediatr. 1993; 13(1):55-64. DOI: 10.1080/02724936.1993.11747625. View

17.

Pittet D, Wenzel R . Nosocomial bloodstream infections. Secular trends in rates, mortality, and contribution to total hospital deaths. Arch Intern Med. 1995; 155(11):1177-84. DOI: 10.1001/archinte.155.11.1177. View

18.

Kotey F, Awugah S, Dayie N, Tetteh-Quarcoo P, Duodu S, Osei M . High prevalence of methicillin-resistant Staphylococcus aureus carriage among infants at the Children's Hospital, Accra, Ghana. J Infect Dev Ctries. 2022; 16(9):1450-1457. DOI: 10.3855/jidc.14839. View

19.

Dayie N, Tetteh-Ocloo G, Labi A, Olayemi E, Slotved H, Lartey M . Pneumococcal carriage among sickle cell disease patients in Accra, Ghana: Risk factors, serotypes and antibiotic resistance. PLoS One. 2018; 13(11):e0206728. PMC: 6224078. DOI: 10.1371/journal.pone.0206728. View

20.

Egyir B, Guardabassi L, Nielsen S, Larsen J, Addo K, Newman M . Prevalence of nasal carriage and diversity of Staphylococcus aureus among inpatients and hospital staff at Korle Bu Teaching Hospital, Ghana. J Glob Antimicrob Resist. 2016; 1(4):189-193. DOI: 10.1016/j.jgar.2013.05.006. View