Browsing by Author "Mills, R.O."
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Item Clonal distribution of pneumococcal serotype 19F isolates from Ghana(Infection, Genetics and Evolution, 2015-04) Sparding, N.; Dayie, N.T.K.D.; Mills, R.O.; Newman, M.J.; Dalsgaard, A.; Frimodt-Møller, N.; Slotved, H.-C.Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide. Pneumococcal strains are classified according to their capsular polysaccharide and more than 90 different serotypes are currently known.In this project, three distinct groups of pneumococcal carriage isolates from Ghana were investigated; isolates from healthy children in Tamale and isolates from both healthy and children attending the outpatient department at a hospital in Accra. The isolates were previously identified and characterized by Gram staining, serotyping and susceptibility to penicillin. In this study, isolates of the common serotype 19F were further investigated by Multi-Locus Sequence Typing (MLST).Overall, 14 different Sequence Types (STs) were identified by MLST, of which nine were novel based on the international MLST database. Two clones within serotype 19F seem to circulate in Ghana, a known ST (ST 4194) and a novel ST (ST 9090). ST 9090 was only found in healthy children in Accra, whereas ST 4194 was found equally in all children studied. In the MLST database, other isolates of ST 4194 were also associated with serotype 19F, and these isolates came from other West African countries. The majority of isolates were penicillin intermediate resistant.In conclusion, two clones within serotype 19F were found to be dominating in pneumococcal carriage in Accra and Tamale in Ghana. Furthermore, it seems as though the clonal distribution of serotype 19F may be different from what is currently known in Ghana in that many new clones were identified. This supports the importance of continued monitoring of pneumococcal carriage in Ghana and elsewhere when vaccines, e.g., PCV-13, have been introduced to monitor the possible future spread of antimicrobial resistant clones. © 2015.Item Epidemiology of pneumococcal carriage in children under five years of age in Accra, Ghana(Infectious Diseases, 2015-03) Mills, R.O.; Twum-Danso, K.; Owusu-Agyei, S.; Donkor, E.S.Background: Although the majority of pneumococcal infections occur in the developing world, pneumococcal epidemiology is poorly understood in these settings. The aim of the study was to investigate the epidemiology of pneumococcal carriage among children younger than 5 years at a paediatric healthcare centre in Ghana. Method: Four-hundred and twenty-three children were randomly sampled and nasopharyngeal specimens were collected from them. The specimens were cultured for Streptococcus pneumoniae, and the isolates were subjected to antibiotic susceptibility testing and serotyping by latex agglutination. Epidemiological data on demographic and clinical features of the study subjects were collected. Results: The prevalence of pneumococcal carriage was 48.9% (207/422), with age groups 43 - 48 months having the highest carriage prevalence. In the multivariate analysis, pneumococcal carriage was significantly associated with runny nose (odds ratio = 1.9, p = 0.003) and day-care attendance (odds ratio = 1.5, p = 0.04). No pneumococcal resistance was observed for ceftriaxone, while the prevalence of resistance to the other antibiotics tested was: cotrimoxazole 100%, ampicillin 88%, tetracycline 78%, penicillin 63% and erythromycin 24%. Fourteen different pneumococcal serogroups/serotypes were identified and serogroup 6 was the most prevalent (30%), followed by serotype 19 (20%). Conclusions: We conclude that pneumococcal carriage among the study children is high and the carried strains have a high level of resistance (> 50%) to several antibiotics. Ceftriaxone is a suitable antibiotic for treating pneumococcal infections in Ghana, and the use of this antibiotic coupled with the pneumococcal vaccination is expected to significantly reduce the burden of pneumococcal disease in the country.