Development of a local antibiogram for a teaching hospital in Ghana

Cornelius C Dodoo; Hayford Odoi; Adelaide Mensah; Karikari Asafo-Adjei; Ruth Ampomah; Lydia Obeng; Jonathan Jato; Araba Hutton-Nyameaye; Thelma A Aku; Samuel O Somuah; Emmanuel Sarkodie; Emmanuel Orman; Kwadwo A Mfoafo; Inemesit O Ben; Eneyi E Kpokiri; Fatima Abba; Yogini H Jani

doi:10.1093/jacamr/dlad024

Development of a local antibiogram for a teaching hospital in Ghana

JAC Antimicrob Resist. 2023 Mar 27;5(2):dlad024. doi: 10.1093/jacamr/dlad024. eCollection 2023 Apr.

Authors

Cornelius C Dodoo¹, Hayford Odoi¹, Adelaide Mensah¹, Karikari Asafo-Adjei², Ruth Ampomah¹, Lydia Obeng¹, Jonathan Jato¹, Araba Hutton-Nyameaye¹, Thelma A Aku¹, Samuel O Somuah¹, Emmanuel Sarkodie³, Emmanuel Orman¹, Kwadwo A Mfoafo¹, Inemesit O Ben¹, Eneyi E Kpokiri⁴, Fatima Abba^{5

6}, Yogini H Jani⁶

Affiliations

¹ School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana.
² Laboratory Department, Ho Teaching Hospital, Ho, Ghana.
³ Pharmacy Department, Kwame Nkrumah University of Science and Technology Teaching Hospital, Kumasi, Ghana.
⁴ Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
⁵ Health Protection Operations Division, UK Health Security Agency, London, UK.
⁶ Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Trust & UCL School of Pharmacy, London, UK.

Abstract

Background: Antimicrobial resistance threatens adequate healthcare provision against infectious diseases. Antibiograms, combined with patient clinical history, enable clinicians and pharmacists to select the best empirical treatments prior to culture results.

Objectives: To develop a local antibiogram for the Ho Teaching Hospital.

Methods: This was a retrospective cross-sectional study, using data collected on bacterial isolates from January-December 2021. Samples from urine, stool, sputum, blood, and cerebrospinal fluid (CSF) were considered as well as, aspirates and swabs from wound, ears and vagina of patients. Bacteria were cultured on both enrichment and selective media including blood agar supplemented with 5% sheep blood and MacConkey agar, and identified by both the VITEK 2 system and routine biochemical tests. Data on routine culture and sensitivity tests performed on bacterial isolates from patient samples were retrieved from the hospital's health information system. Data were then entered into and analysed using WHONET.

Results: In all, 891 pathogenic microorganisms were isolated from 835 patients who had positive culture tests. Gram-negative isolates accounted for about 77% of the total bacterial species. Escherichia coli (246), Pseudomonas spp. (180), Klebsiella spp. (168), Citrobacter spp. (101) and Staphylococcus spp. (78) were the five most isolated pathogens. Most of the bacterial isolates showed high resistance (>70%) to ampicillin, piperacillin, ceftazidime, ceftriaxone, cefotaxime, penicillin G, amoxicillin, amoxicillin/clavulanic acid, ticarcillin/clavulanic acid and trimethoprim/sulfamethoxazole.

Conclusions: The isolates from the various samples were not susceptible to most of the antibiotics used in the study. The study reveals the resistance patterns of E. coli and Klebsiella spp. to some antibiotics on the WHO 'Watch' and 'Reserve' lists. Using antibiograms as part of antimicrobial stewardship programmes would optimize antibiotic use and preserve their efficacy.