Innocent Afeke

Urinary tract infections (UTIs) remain a significant public health concern, with evolving patterns in prevalence and antimicrobial resistance. This retrospective study, conducted at the Greater Accra Regional Hospital in Accra, Ghana, analyzed 11,280 urine cultures obtained exclusively from female patients from 2019 to 2022 to assess trends in UTI burden, prevalence stratified by age and month, and antimicrobial susceptibility patterns. In all, urine pathogens were isolated in 4475 (39.67%) of the samples tested. Of the total number of uropathogens isolated, majority of them were bacterial pathogens (94.21%), with an increasing proportion of fungal infections, specifically candida species (5.79%). Irrespective of the year, the highest prevalence of uropathogens were consistently recorded in the month of May, while individuals aged ≥ 90 years exhibited the greatest odds of infection in 2020 (aOR: 1.88, p = 0.039). Escherichia coli (30.51%) and Staphylococcus aureus (15.16%) were the most prevalent Gram-negative and Gram-positive pathogens, respectively. Antimicrobial susceptibility testing revealed declining antibiotic effectiveness over time, with notable exceptions for gentamicin (97.4% effectiveness against Enterococcus spp.) and ofloxacin (82.9% against Enterococcus spp.). Alarmingly, most antibiotics exhibited effectiveness rates below 20% by 2022, underscoring the growing resistance challenge. These findings, drawn from a key healthcare facility in Ghana’s capital, highlight the dynamic nature of UTIs and the urgent need for targeted interventions, optimized antimicrobial stewardship, and continuous monitoring of resistance patterns to improve patient outcomes.

INTRODUCTION: Coagulase-negative staphylococci (CoNS) have emerged as significant pathogens in neonatal intensive care units (NICUs), especially as a leading cause of neonatal sepsis. In low-income co

INTRODUCTION: Despite ongoing efforts, the health burden of neonatal infection remains unacceptably high due to major challenges, including the hurdle of determining the origin of infection. In this s

Background: Proliferation of non-falciparum species of plasmodium into predominant falciparum populations compromises the utility of monobiomaker based malaria Rapid Diagnostic Test (mRDT). This study evaluated the validity of a mono-biomarker based Carestart®) and Paracheck™ mRDTs in use at a Military Medical Centre in Ghana. Methodology: The study was designed to assess the validity of named mRDTs in a setting in Ghana. Blood samples collected from a consecutive series of 207 febrile patients in the months of June and July 2020, were tested for malaria parasites, using the mRDTs and microscopy as the gold standard. Prevalence, validity, and reliability metrics were determined using Frequentist, Receiver Operating Characteristics (ROC), and Kappa statistics, respectively. Results: The prevalence was 23.2% and 12.3% using microscopy and candidate mRDT, respectively. Sensitivities and specificities were 53.2% and 98.1% (Carestart®), 45.8% and 99.4% (Paracheck), respectively. Neither ROC analysis showed a significant disparity between mRDTs (Carestart®: AUROC=0.75 vs Paracheck™: AUROC=0.73), nor the reliability index showed disagreement between both mRDTs (Cronbach’s α = 0.92). But there was significant disagreement between microscopy and mRDTs (Carestart®: Kappa=0.58 vs Paracheck™: Kappa=0.55). Conclusion: The use of a monobiomaker mRDTs in this study led to a significant variation between the ‘internal’ and ‘ecological’ validity metrics. Averagely, 84% mRDT false negatives was non-falciparum. It is therefore, critical to accelerate the implementation of WHO’s recommendation to switch from mono to multiple biomarker (s)-based mRDTs for detecting both falciparum and non-falciparum species. Extended research is needed to consolidate our understanding of the dynamics of malaria among our military personnel exposed to non-falciparum plasmodium.

INTRODUCTION: We compared the antimicrobial resistance profile of young infants´ clinical isolates (from blood samples) of Staphylococcus epidermidis and haemolyticus with those colonizing mothers, clinical staff, and students. Also, screened for resistance to the watch and reserve classified groups, antibiotics not prescribed in the Ho Teaching Hospital (HTH), Ghana. METHODS: a cross-sectional study was conducted from March to June 2018 to determine the antimicrobial susceptibility of twenty-one antimicrobials for 123 isolates consisting of 54 S. epidermidis and 69 S. haemolyticus cultured from the participants. VITEK2 was used for antimicrobial susceptibility testing. Staphylococcal species were identified using matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF). Statistical analysis was done with grad-pad prism. RESULTS: for S. epidermidis, clinical staff isolates have the highest methicillin-resistant (65%), followed by young infants´ (50%) and mothers´ and students´ twenty-five percent each. Both young infants and clinical staff´s S. haemolyticus isolates have 100% methicillin-resistant, while mothers´ and students´ ones have 82% and 63%, respectively. We have identified resistance to one watch (teicoplanin), two reserves (tigecycline and fosfomycin) antimicrobial groups, and mupirocin, an unclassified group. CONCLUSION: identifying coagulase-negative staphylococci (CoNS) resistance to watch and reserve groups of antimicrobials in a non-previously exposed hospital calls for further studies to determine molecular mechanisms of resistance to these antimicrobials.

Infective endocarditis (IE), characterized by inflammation of the endocardial surface of the heart and its valves, results from infections caused by Staphylococcus, Streptococcus and Acinetobacter ... Plain language summary Infective endocarditis (IE), known as inflammation of the thin membrane that lines the inside of the heart, results from infections from microbes (e.g., Staphylococcus, Strep...

Data on molecular characterization of coagulase-negative staphylococci causing neonatal sepsis in low-income countries are highly limited. This report highlights the isolation of three Staphylococcus epidermidis strains, NGASs, from blood samples from neonates, with unknown transmission sources. Pathogenic factors and sources of transmission of these strains warrant further investigation.

Background: Candida is the leading cause of vaginitis, and 75% of women have at least one episode of infection in their lives, with pregnancy being a predisposing factor. If left untreated, vulvovaginal candidiasis (VVC) can lead to chorioamnionitis with subsequent abortion, prematurity and congenital infection of the neonate. We aimed to determine the prevalence of VVC, identify the recent and most frequently occurring species of Candida in pregnant women, and determine the most effective antifungal drug of choice for treatment. Method: A prospective cross-sectional study in which 176 high vaginal swab samples of consented pregnant women visiting the antenatal clinic from February 2018 to April 2018 were subjected to direct gram smear and culture for Candida isolation. Candida isolates were identified using a germ tube test and HiCrome Candida differential agar. Candida isolates were then subjected to a disk diffusion method using fluconazole (25 μg), nystatin (100 units), and voriconazole (1 μg) on Mueller-Hinton agar supplemented with 2% (w/v) glucose and 0.5 μg/ml methylene blue dye to determine the susceptibility pattern as per the guidelines of the Clinical Laboratory Standard Institute (CLSI). Chi-square analysis was used to ascertain the significant association of participants’ sociodemographics and clinical presentations to VVC. A univariate logistic regression model was used to identify potential risk factors of VVC. Results: The prevalence of VVC among our study participants was 30.7%. Non-albicans Candida (NAC) and Candida albicans had a prevalence of 74.1 and 25.9%, respectively. Candida glabrata was the most common species, followed by Candida albicans, Candida krusei, and Candida parapsilosis. 50.0, 18.5 and 3.7% of Candida species were susceptible to voriconazole, fluconazole and nystatin, respectively, whereas 37.0, 48.1 and 9.3% of Candida species were resistant to voriconazole, fluconazole and nystatin, respectively. The majority of isolates were susceptible dose dependent to all three antifungal agents, with voriconazole being the most efficacious antifungal agent. There was no significant association between participants’ socio-demographic information and clinical presentations to VVC. Conclusion: The prevalence of VVC was high in the study area. C. glabrata was found to be the most common cause of VVC among the pregnant women attending antenatal clinics, in the Ho Municipality region of Ghana. The majority of the Candida isolates were susceptible and resistant to voriconazole and fluconazole, respectively.

Background: Obesity is increasingly becoming a pandemic considering the many risks it pose to other disease conditions. Obesity is largely a measure of adiposity, however, adiposity is not centralized in the human body. This makes it difficult for any single method to adequately represent obesity and by extension the risks specific areas of adipose accumulation pose to specific disease conditions. Subjects/Methods: We evaluated the prevalence of obesity in a cohort of Ghanaian women using the body mass index (BMI) and further sought to evaluate how it compares to other methods of estimating adiposity and the suitability of any particular methods representing obesity in general. We used anthropometry and bioimpedance derived measures of adiposity and derived other indices such as the abdominal volume index (AVI), body adiposity index (BAI) and conicity index (CI). Results: Waist and hip circumference, body fat (%BF) and visceral fat (VF) were positively correlated to BMI whereas skeletal muscle mass was negatively correlated. Physical activity indices did not show any significant correlation with BMI. Prevalence of obesity was 16% and 31% using BMI and %BF respectively. Receiver operating characteristic analysis showed that whereas BMI is effective in predicting underweight, normal weight and obesity it was a poor predictor of overweight. Conclusions: There was also no single measure that could adequately predict obesity as an accumulation fat. Hence, we developed and propose a model as a factor of BAI, %BF, VF and BMI. This model should correctly represent a person’s adiposity status and hence should be evaluated in large cohort studies.