Staphylococcus aureus Nasal Colonization among Children with Sickle Cell Disease at the Children's Hospital, Accra: Prevalence, Risk Factors, and Antibiotic Resistance.

The aim of this study was to investigate S. aureus carriage among children with sickle cell disease (SCD), including the prevalence, risk factors, and antibiotic resistance. The study was cross-sectional, and involved 120 children with SCD recruited at the Princess Marie Louise Children's Hospital (PML) in Accra and 100 apparently healthy children from environs of the hospital. Nasal swab samples were collected from the study participants and cultured for bacteria. Confirmation of S. aureus and methicillin-resistant Staphylococcus aureus (MRSA) isolates were done using the tube coagulase test and mecA polymerase chain reaction, respectively. All the S. aureus isolates were tested against standard antimicrobial agents using the Kirby-Bauer method. A structured questionnaire was used to obtain the socio-demographic and clinical data of the study participants. Binary logistic regression was used to identify determinants of S. aureus and MRSA carriage among the study participants. The nasal carriage prevalence of S. aureus was 33.3% (n = 40) and 10% (n = 10) among the participants of the SCD and control groups, respectively. As regards MRSA nasal carriage prevalence, the respective values were 3.33% (n = 4) and 0.00% (n = 0). SCD was significantly associated with S. aureus colonization (p < 0.0001, OR = 4.045), but not MRSA colonization (p = 0.128). In the SCD group, the significant predictors of S. aureus carriage were increasing age (p = 0.003; OR = 1.275) and living in self-contained apartments (p = 0.033; OR = 3.632), whereas male gender (p = 0.018; OR = 0.344) and the practice of self-medication (p = 0.039; OR = 0.233) were protective of S. aureus carriage. In the control group, a history of hospitalization in the past year was a risk factor for the carriage of S. aureus (p = 0.048; OR = 14.333). Among the participants of the SCD and control groups, respectively, the resistance prevalence recorded by S. aureus against the various antibiotics investigated were penicillin (100% each), cotrimoxazole (27.5% vs. 20%), tetracycline (25% vs. 50%), rifampicin (82.5% vs. 50%), erythromycin (30% vs. 20%), clindamycin (32.5% vs. 50%), gentamicin (7.5% vs. 20%), cefoxitin (27.5% vs. 20%), linezolid (30% vs. 40%), and fusidic acid (95% vs. 80%). The proportion of S. aureus isolates that were multidrug resistant (MDR) was 92.5% (37/40) in the SCD group and 100% (10/10) in the control group.

Estimated Burden of Serious Fungal Infections in Ghana.

Fungal infections are increasingly becoming common and yet often neglected in developing countries. Information on the burden of these infections is important for improved patient outcomes. The burden of serious fungal infections in Ghana is unknown. We aimed to estimate this burden. Using local, regional, or global data and estimates of population and at-risk groups, deterministic modelling was employed to estimate national incidence or prevalence. Our study revealed that about 4% of Ghanaians suffer from serious fungal infections yearly, with over 35,000 affected by life-threatening invasive fungal infections. Incidence of cryptococcal meningitis, Pneumocystis jirovecii pneumonia, and disseminated histoplasmosis cases in AIDS was estimated at 6275, 12,610 and 724, respectively. Oral and esophageal candidiasis collectively affect 27,100 Ghanaians and 42,653 adult asthmatics are estimated to have fungal asthma. We estimate a prevalence of 12,620 cases of chronic pulmonary aspergillosis (CPA and an incidence of 1254 cases of invasive aspergillosis (IA). Estimated cases of candidemia and candida peritonitis cases were 1446 and 217, respectively. The estimated prevalence of recurrent vulvovaginal candidiasis (RVVC) and tinea capitis was 442,621 and 598,840, respectively. Mucormycosis and fungal keratitis each may affect 58 and 810 Ghanaians. These data highlight the urgent need for intensified awareness to improve diagnosis and management.

Bacteriological quality of the wastewater used for irrigation at the vegetable farms in Korle-bu Teaching Hospital, Accra Metropolis, Ghana.

Many developing countries, including Ghana, are water stressed. As such, farmers, particularly those in urban areas, have adopted the use of wastewater for irrigation. This study evaluated the bacteriological water quality of the wastewater used for irrigation in the vegetable farms at Korle-Bu Teaching Hospital (KBTH), Accra Metropolis, Ghana. In all, 40 wastewater samples were collected and analysed bacteriologically using the total aerobic plate count method. The isolated bacteria were identified biochemically using Bergey's manual for determinative bacteriology. Mean total bacterial colony count values in the range of 2.75-4.44 × 105 CFU/100 mL were isolated which far exceeds values of 1 × 103/100 mL recommended by the World Health Organization (WHO) for unrestricted irrigation of crops likely to be eaten raw. Enterobacter cloacae (51.4%), Klebsiella sp. (24.1%), Pseudomonas aeruginosa (11.3%), Salmonella typhi (10.6%), Escherichia coli (2.2%) and Proteus sp. (0.4%) were the predominant bacteria isolated. Growers should use treated wastewater for farming while processors and consumers should minimize contamination risks of produce from the vegetable farms/garden to the plate.

Antibacterial activity of plants used in traditional medicines of Ghana with particular reference to MRSA.

ETHNOPHARMACOLOGICAL RELEVANCE: : In an ethno botanical survey carried out in the Akwapim-North district of the Republic of Ghana, 25 plant species, used in traditional medicine to treat skin disease and/or to treat antimicrobial (viral, bacterial or protozoan) infections were identified. AIM OF STUDY: : To investigate the antimicrobial activity of traditional Ghanaian medicines with special interest in anti-methicillin-resistant Staphylococcus aureus (MRSA) activity. MATERIALS AND METHODS: : Chloroform, ethanol and aqueous extracts (including use of a Stomacher) of these plants were prepared and agar-well diffusion tests, MIC's and MBC's were used to investigate antimicrobial activity. RESULTS: Extracts of 13 plant species inhibited the growth of one or more of the following bacteria: MRSA, methicillin-sensitive Staphylococcus aureus (MSSA), Streptococcus pyogenes, Escherichia coli, Pseudomonas aeruginosa and Proteus vulgaris. Extracts from 11 of these 13 plant species also inhibited the growth of three or more of 14 additional clinical isolates of MRSA. Aqueous extracts of Alchornea cordifolia were active against all 21 bacterial strains tested and showed the highest levels of antibacterial activity overall with MIC's against MRSA in the range of 1.6-3.1 mgml(-1) and MBC's in the range of 6.3-12.5 mgml(-1). CONCLUSIONS: : The presence of antibacterial activity in extracts of Elaeophorbia drupifera, Rauwolfia vomitoria and the leaves of Solanum verbascifolium, plants traditionally used to treat skin infections, are reported for the first time. Extracts from Alchornea cordifolia, also used to treat wounds, had the widest spectrum of antibacterial activity.