Antimicrobial Resistance Levels of Non-Tuberculous Bacteria Isolates from Sputum of TB Patients in Ghana

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2024 Dec 24

PMID 39717061

Authors

Portia Abena Morgan

Desmond Opoku Ntiamoah

Prince Asare

Ishaque Siam Mintah

Stephen Osei-Wusu

Augustine Asare Boadu

Emelia Konadu Danso

Ivy Naa Koshie Lamptey

Emmanuel Afreh

Amanda Tetteh

Adwoa Asante-Poku

Isaac Darko Otchere

Dorothy Yeboah-Manu

Affiliations

Soon will be listed here.

Abstract

Background: Patients with tuberculosis (TB) often harbor diverse bacteria in their sputum, including both commensal and opportunistic pathogens. This study aimed to characterize the sputum microbiota of TB patients before and after the intensive phase of anti-TB treatment and assess changes in bacterial diversity and antibiotic resistance profiles.

Methods: A total of 162 patients with TB (128 males, 34 females; age range 18-82 years) provided sputum samples at baseline, of which 72 provided follow-up sputum after two months of intensive phase treatment. Sputum samples were cultured on standard agar plates, and distinct colonies were identified by Gram staining and bio-typing using MALDI-TOF mass spectrometry. Antibiotic susceptibility testing of the identified Gram-positive and Gram-negative bacteria was performed using the Kirby-Bauer method according to the CLSI guidelines.

Results: At baseline, 209 bacterial isolates were recovered, dominated by Gram-positive bacteria (GPB), particularly (19.6%) and (13.9%). After treatment, the isolation rate significantly decreased (from 129% to 95.8%; p = 0.000002), with a shift towards Gram-negative bacteria (GNB) dominated by . High rates of antibiotic resistance were observed for both the GNB and GPB, notably to ampicillin (86.7%), tetracycline (74%), amoxicillin (70.3%), and sulfamethoxazole (63%) for GNP, and PEN (76.9%) for the GPB. 53% of isolates were phenotypic Methicillin-resistant (MRSA) and 57.7% of suspected extended-spectrum (ESBL) producers were confirmed positive, predominantly carrying the gene.

Conclusion: The observed antibiotic resistance among the identified isolates, including MRSA and ESBL, underscores the need for routine antibiotic susceptibility testing and judicious antibiotic use in Ghana. Further research is needed to explore the long-term consequences of these microbiome shifts on TB treatment outcomes and risk of secondary infections.

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