Phenotypic and Genotypic Profile of Enterobacteriaceae Isolated at a Teaching Hospital in Ghana
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Background
Antibiotic resistance in Enterobacteriaceae continue to rise and its implications on health care delivery intensified. We investigated the genetic basis for antimicrobial resistance (AMR), virulence genes and associated plasmids in Enterobacteriaceae isolates at a teaching hospital in Ghana.
Materials and methods
Antimicrobial susceptibility testing was performed on archived isolates. Whole genome sequencing was performed on a subset of the isolates which were either multi-drug resistant or extend spectrum ß-lactamases (ESBL)producing. Bioinformatic analyses were performed for speciation, identification of AMR and virulence genes as well as associated plasmids.
Results
The 100 Enterobacteriaceae isolates included in this study expressed high phenotypic resistance to ß-lactams, and high susceptibility to aminoglycosides. The 20 WGS isolates were identified genotypically based on housekeeping genes Escherichia coli (8/20, 40%), Klebsiella pneumoniae (8/20, 40%), Enterobacter cloacae (2/20, 10%), and Salmonella enterica (1/20, 5%). These harboured 139 unique antibiotic resistant genes encoding resistance against ß-lactams (65/139), aminoglycosides (23/139), fluoroquinolones (45/139), tetracyclines (35/139), phenicols (28/139), and sulphonamides (9/139). Subsequent AST performed revealed that (74/79, 94%) were ESBL producers, and (9/79,11%) were CRE. The isolates expressed 8 main categories of virulence factors with adherence, effector delivery systems, and metabolic factors predominating in decreasing order. Additionally, 26 unique plasmid replicons of both I-complex and colicin plasmids were detected.
Conclusion
We identified marked phenotypic and genotypic evidence of antimicrobial resistance to commonly used antibiotics in the isolates at the hospital.
