Passing on dangerous naked explosives: the state of multiple antibiotic resistant Enterobacteriaceae in Cape Coast, Ghana.
The dynamisms involved in bacterial drug resistance, emergence and spread of multiple antibiotic resistant Enterobacteriaceae in Ghana are poorly understood. The current state of antibiotic resistance is gradually becoming alarming. To make matters worse, the factors that drive the transmission of antibiotic resistance among organisms in Ghana are still poorly understood. The isolation of multi-antibiotic resistant Enterobacteriaceae to ß-lactams, the first, second and third generation cephalosporins from circulating coin currencies and meat sources in Cape Coast, Ghana, is a major concern as it poses a serious threat to the entire healthcare system. E. coli, Enterobacter spp, Shigella spp, Klebsiellaspp, Pseudomonas spp, and Proteus spp showed resistance to second and third generation cephalosporins, an effective antibiotic against Enterobacteriaceae species. There is a possibility that this extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae in circulation will spread rapidly with limited timely treatment to curb the infections. These microbes cause a range of infections including acute diarrhoea, respiratory infection, urinary tract infections (UTI), bacteremia, sepsis, pneumonia, cystitis, pyelonephritis, and lung abscess. The easy spread of this multi-antibiotic resistant Enterobacteriaceae through contact with contaminated surfaces and by person-to-person contact makes it major public health concern as it has a high implication on the health facilities of the region which have limited resources. The isolation of MDR Enterobacteriaceae from circulating coin currencies and meat sources gives an indication of an individual's multiple points of contact with these pathogens during daily routines, risk of infection and possible transmission to another person. The impending danger of possible outbreak of multiple ESBL-E resistant strains requires immediate public health measures to circumvent an epidemic outbreak in Ghana. Understanding the underlying mechanisms of ESBL-E transmission would be essential in providing permanent control measures to deal with drug resistance in Ghana. Personal hygiene and proper handling of currencies are encouraged to mitigate the spread of drug- resistant pathogens.
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Asare Kwame Kumi, MPhil, PhD
Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University