Multidrug Resistance in Gram-Negative Bacteria isolated in a Tertiary-Care Hospital in Northern Ghana from 2017-2019

Abstract

Background: Multidrug resistance exist within a wide variety of clinically significant pathogens and poses a serious and growing global public health threat. This study aimed to determine the incidence, patterns, and trends of multidrug resistance of gram-negative bacterial isolates in clinical specimens cultured at the Tamale Teaching Hospital Laboratory. Methods: This retrospective study analyzed gram-negative bacteria isolates and sensitivity test results of patients who visited the Tamale Teaching Hospital laboratory in Ghana, West Africa from 2017 to 2019 Results: A total of 2769 gram-negative bacteria isolates and their phenotypic AST results were analyzed in this study. A total of 1297 gram-negative bacteria were isolated from urine samples representing 46.8% of all the isolates followed by isolates from sputum samples and wound swabs. Escherichia coli (23.8%) is the highest isolated gram-negative bacteria in all samples with, predominance from urine samples making up 33.2%. All gram-negative bacteria isolated from 2017-2019 showed significant multidrug resistance between 60% and 95.5%. Klebsiella pneumonia similarly showed increased multidrug resistance levels year on year; 2017(84%), 2018(89.5%) and 95.1% in 2019. Pseudomonas aeruginosa which showed relatively low multidrug resistance rates (65.8%) was, still determined to demonstrate increased resistance from 2017(59.5%) to 2019(78.7%). Gram-negative bacteria showed the highest susceptibility to antibiotics in the aminoglycoside group with amikacin the most effective. Enterobacter spp resistance to amikacin was as low as 16.2%, Escherichia coli (11.8%) and Klebsiella pneumoniae were determined to be 17.7%. Conclusion: The study has shown high levels of multidrug-resistant gram-negative bacteria commonly isolated as the causative organisms in a range of infections. There is high resistance to penicillins, cephalosporins, and fluoroquinolones among major gram-negative pathogens. Aminoglycosides exhibited the least levels of resistance to isolated gram-negative bacteria in the Tamale Teaching Hospital.