Role of CTX-M-15 gene in spread of extended-spectrum beta-lactamases among immunocompetent patients in Ghana
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
African Journal of Laboratory Medicine
Abstract
Background: Patients with faecal carriage of extended-spectrum beta-lactamases (ESBL)-
producing Enterobacterales serve as reservoirs and sources of dissemination and infection.
Objective: This report examined immunocompetent patients for faecal carriage of ESBL producing Enterobacterales in a district care hospital setting in Ghana.
Methods: Between March 2019 and May 2020, cross-sectional sampling was performed to
enrol patients and conduct questionnaire-structured interviews for factors that predispose
patients to ESBL faecal carriage. Faecal samples from study patients were quantified for ESBL producing Enterobacterales. The ESBL genes were characterised by polymerase chain reaction
and sequencing.
Results: The overall proportion of ESBL faecal carriage was 35.5% (n = 38/107). The blaCTX-M
gene, mostly CTX-M-15, was detected in 89.5% (n = 34/38) of the ESBL-producing isolates. The
other ESBL types included blaSHV (n = 3) and blaOXA (n = 1). The CTX-M-15-positive isolates,
when present in a faecal sample compared to the non-ESBL-CTX-M-15 isolates, constituted the
predominant faecal Enterobacterales, with significantly higher colony counts than all other
enterobacteria in that sample. In multivariate regression, independent risk factors for faecal
carriage of ESBL-producing Enterobacterales were hospitalisation in the past year, infections
since admission, use of antibiotics in the past 6 weeks, and admission from another hospital.
Conclusion: The study found that CTX-M-15-producing isolates were the predominant faecal
Enterobacterales, and that further investigations are needed to determine the reasons behind
this dominance.
What this study adds: The CTX-M-15-producing isolates dominance in this study shows the
misuse and abuse of antibiotics in an African medical facility and indicates the potential role
of immunity in controlling ESBL spread, which is to be investigated further.
Description
Research Article
Keywords
extended-spectrum beta-lactamases, prevalence, inpatient
Citation
How to cite this article: Obeng-Nkrumah N, Tawiah-Abrokwa GD, Owusu E, et al. Role of CTX-M-15 gene in spread of extended spectrum beta-lactamases among immunocompetent patients in Ghana. Afr J Lab Med. 2023;12(1), a2135. https://doi.org/10.4102/ajlm. v12i1.2135