Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana.
<h4>Background</h4>Vulnerable groups, such as pregnant women, are at increased risk of potentially life-threatening infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) for both mother and newborn. However, data regarding ESBL-E carriage and associated ris...
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0310058 |
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| author | Noah Obeng-Nkrumah Appiah Korang-Labi Paul Kwao Beverly Egyir Benjamin D Nuertey George Hedidor Gifty Boateng Kwaku Asah-Opoku Thomas Dankwah Esther Okine Japheth A Opintan |
| author_facet | Noah Obeng-Nkrumah Appiah Korang-Labi Paul Kwao Beverly Egyir Benjamin D Nuertey George Hedidor Gifty Boateng Kwaku Asah-Opoku Thomas Dankwah Esther Okine Japheth A Opintan |
| author_sort | Noah Obeng-Nkrumah |
| collection | DOAJ |
| description | <h4>Background</h4>Vulnerable groups, such as pregnant women, are at increased risk of potentially life-threatening infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) for both mother and newborn. However, data regarding ESBL-E carriage and associated risk factors in Ghanaian pregnant women remain scarce.<h4>Objective</h4>This study aimed to determine the prevalence of ESBL-E carriage and its associated risk factors among pregnant women attending the antenatal clinic at the Korle Bu Teaching Hospital.<h4>Methods</h4>A systematic sample of 700 pregnant women with gestational age ≥ 34 weeks attending the antenatal clinic at Korle Bu Teaching Hospital was included in the study. After administering a structured questionnaire to assess potential risk factors associated with ESBL-E carriage, patients were given a sterile stool container to submit at least 1 g of stool specimen. Recovered isolates from faecal specimens were identified using MALDI-TOF-MS technology. These isolates were then subjected to susceptibility testing and ESBL identification. A random subset of 24 ESBL-producing Escherichia coli isolates was whole-genome sequenced on the MiSeq Illumina platform. Risk factors associated with ESBL-E carriage were determined using multivariable logistic regression analysis.<h4>Results</h4>Among the 700 pregnant women, 42% (294) carried ESBL-E. The predominant ESBL-producing Enterobacterales were Escherichia coli (95%). Fifty percent (50%) of ESBL-E were multidrug resistant isolates (MDRs). Whole-genome sequencing of 24 ESBL-producing E. coli isolates revealed that blaCTX-M-15 (96%) was the most prevalent ESBL gene type. Notably, most isolates belonged to commensal phylogenetic groups (A, B1, and C; 88%). Having a primary level of education (aOR 1.45, 95% CI 1.05-1.96) and consuming legumes as the main source of protein (aOR 0.17, 0.40-0.83) were significantly associated with intestinal carriage of ESBL-E.<h4>Conclusion</h4>This study identified a high prevalence of ESBL-E and MDR-ESBL-E carriage among pregnant women. Our findings underscore the urgent need for public health interventions to control the spread of AMR. |
| format | Article |
| id | doaj-art-ca66443487a041e09d57e9ba29e30b8e |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-ca66443487a041e09d57e9ba29e30b8e2024-12-13T05:31:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011911e031005810.1371/journal.pone.0310058Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana.Noah Obeng-NkrumahAppiah Korang-LabiPaul KwaoBeverly EgyirBenjamin D NuerteyGeorge HedidorGifty BoatengKwaku Asah-OpokuThomas DankwahEsther OkineJapheth A Opintan<h4>Background</h4>Vulnerable groups, such as pregnant women, are at increased risk of potentially life-threatening infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) for both mother and newborn. However, data regarding ESBL-E carriage and associated risk factors in Ghanaian pregnant women remain scarce.<h4>Objective</h4>This study aimed to determine the prevalence of ESBL-E carriage and its associated risk factors among pregnant women attending the antenatal clinic at the Korle Bu Teaching Hospital.<h4>Methods</h4>A systematic sample of 700 pregnant women with gestational age ≥ 34 weeks attending the antenatal clinic at Korle Bu Teaching Hospital was included in the study. After administering a structured questionnaire to assess potential risk factors associated with ESBL-E carriage, patients were given a sterile stool container to submit at least 1 g of stool specimen. Recovered isolates from faecal specimens were identified using MALDI-TOF-MS technology. These isolates were then subjected to susceptibility testing and ESBL identification. A random subset of 24 ESBL-producing Escherichia coli isolates was whole-genome sequenced on the MiSeq Illumina platform. Risk factors associated with ESBL-E carriage were determined using multivariable logistic regression analysis.<h4>Results</h4>Among the 700 pregnant women, 42% (294) carried ESBL-E. The predominant ESBL-producing Enterobacterales were Escherichia coli (95%). Fifty percent (50%) of ESBL-E were multidrug resistant isolates (MDRs). Whole-genome sequencing of 24 ESBL-producing E. coli isolates revealed that blaCTX-M-15 (96%) was the most prevalent ESBL gene type. Notably, most isolates belonged to commensal phylogenetic groups (A, B1, and C; 88%). Having a primary level of education (aOR 1.45, 95% CI 1.05-1.96) and consuming legumes as the main source of protein (aOR 0.17, 0.40-0.83) were significantly associated with intestinal carriage of ESBL-E.<h4>Conclusion</h4>This study identified a high prevalence of ESBL-E and MDR-ESBL-E carriage among pregnant women. Our findings underscore the urgent need for public health interventions to control the spread of AMR.https://doi.org/10.1371/journal.pone.0310058 |
| spellingShingle | Noah Obeng-Nkrumah Appiah Korang-Labi Paul Kwao Beverly Egyir Benjamin D Nuertey George Hedidor Gifty Boateng Kwaku Asah-Opoku Thomas Dankwah Esther Okine Japheth A Opintan Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana. PLoS ONE |
| title | Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana. |
| title_full | Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana. |
| title_fullStr | Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana. |
| title_full_unstemmed | Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana. |
| title_short | Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana. |
| title_sort | extended spectrum beta lactamase producing enterobacterales in human health experience from the tricycle project ghana |
| url | https://doi.org/10.1371/journal.pone.0310058 |
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