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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Main Authors: 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
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
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.
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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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