Hindawi
Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 2021, Article ID 6647959, 8 pages
https://doi.org/10.1155/2021/6647959
Research Article
Multidrug-Resistant Bacteria on the Mobile Phones and
Computer Keyboards of Healthcare University Students in Ghana
Michael Olu-Taiwo, Christian Afotey Laryea, David Kweku Mykels,
and Akua Obeng Forson
Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, College of Health Sciences,
University of Ghana, Legon, Ghana
Correspondence should be addressed to Akua Obeng Forson; obeng.akua@yahoo.com
Received 6 December 2020; Revised 9 March 2021; Accepted 31 March 2021; Published 15 April 2021
Academic Editor: Gabriele Messina
Copyright © 2021 Michael Olu-Taiwo et al. ,is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Globally, mobile phones and computers (laptops and desktops) are indispensable part of human lives for communication,
entertainment, and educational purposes. However, there are concerns about the increasing risk of bacterial contamination and
antibiotic resistant trends from the surfaces of these devices. ,is study aims to assess bacterial contamination of mobile phones
and computer keyboards and their resistant profile at the University of Ghana, Korle-Bu Campus, Accra. ,is was a cross-
sectional study conducted from March to June 2017 with 240 swabs collected from the surfaces of mobile phones and computer
keyboards used by healthcare students. Swabs were cultured onMacConkey, blood, and mannitol salt agar. Bacteria identification
was performed with a standard bacteriological method. A total of 91 bacterial isolates were obtained from the devices, and they
were tested against 9 commonly used antibiotics by the Kirby–Bauer disc method. ,e study revealed mobile phones and
computer keyboards had contamination levels of 83.3% and 43.3%. Bacteria isolated included Staphylococcus epidermidis (25.4%),
Klebsiella spp. (12.9%), Staphylococcus aureus (9.2%), Escherichia coli (6.7%), Pseudomonas spp. (5.4%), Enterobacter cloacae
(2.1%), and Enterobacter spp. (1.7%). Overall, 91 bacterial isolates were highly resistant to ampicillin (96.7%) and tetracycline
(75.8%) and moderately resistant to chloramphenicol (49.5%) with lower resistance to cefotaxime (18.7%), ceftadizime (14.2%),
ciprofloxacin (25.3%), and gentamycin (24.7%). Additionally, 45.1% of isolates were multidrug resistant. Findings from this study
revealed mobile phones and computer keyboards of healthcare students in the university were contaminated with pathogenic
bacteria. Hence, frequent hand hygiene and disinfection of mobile phones and computer keyboard surfaces is encouraged to
minimize the spread of resistant bacteria pathogens.
1. Introduction However, due to the immense benefits derived from usage of
mobile phones and computers systems, their potential risk to
Globally, mobile devices have emerged as a necessity for human health may have been overlooked, since disinfection is
communication, entertainment, and educational purposes virtually absent [4, 7]. ,e incessant handling of mobile
[1–3]. In 2018, the global digital agencies estimated worldwide phones, computer keyboards, and other electronic devices by
mobile phone users to be over 5.11 billion [3]. Due to their various users exposes these devices to an array of pathogenic
relatively affordable prices and enhanced functions, mobile bacteria [7, 8]. Many of these pathogens have the capacity to
phone are found inmost places in Ghana, and currently, there survive on environmental surfaces; therefore, these could be
are over 19 million mobile-phone users and 9.28 million potential sources of infection in humans [9, 10].,ese devices
active mobile Internet users [3, 4]. Personal computers have have been found to act as formites for transmission of
likewise become a vital aspect of day-to-day activities in pathogenic agents such as Staphylococcus aureus, Escherichia
homes, offices, schools, hospitals, and laboratories [5, 6]. coli, and Pseudomonas spp. [7, 11, 12]. Some of these
2 Canadian Journal of Infectious Diseases and Medical Microbiology
pathogenic bacteria have been found to possess multidrug- Mannitol salt agar (Oxoid, Cambridge, UK) and incubated at
resistance capacities [12, 13]. At present, antibiotic drug re- 37oC for 18–24 hours for bacterial growth (34).
sistance has become a global issue that has led to an increase
in morbidity and mortality, high treatment failures, and in-
creased healthcare costs [13, 14]. 2.4. Identification of Bacterial Isolates. Identification of
Studies conducted in Ghana, Egypt, Ethiopia, and Pakistan bacterial isolates was performed by first subculturing from
on mobile phone and other devices have reported bacterial primary culture plates to obtain pure culture colonies.
contamination prevalence of 100%, 100%, 100%, and 61.3%, Bacteria identification from pure culture plates was based on
respectively [1, 5, 7, 12]. Also, Tagoe et al.’s [12] study revealed colonial morphology, and a representative colony on each
81.8% of bacterial isolates were found to be pathogenic and plate was picked, Gram stained, and further tested using
100% of these bacterial isolates were resistant to ampicillin, indole, methyl red, citrate, oxidase, and Voges–Proskauer
cloxacillin, and penicillin. In another study in Nigeria [15], a test and urease, and coagulase tests [17]. An API 20 E
bacterial contamination prevalence of 80% was reported and identification system (bioMerieux SA, Marcy l‟Etoile,
bacteria isolated included Staphylococcus aureus (53.6%), France) was also used to confirm the Gram-negative isolates.
Escherichia coli (25.11%), and Klebsiella spp. (14.5%). How-
ever, in Ghana, there are limited data on bacterial contami- 2.5. Antimicrobial Susceptibility Test of Pathogenic Bacterial
nation of mobile phones and computer keyboards with their Isolates. Antibiotic susceptibility testing was performed for
associated antibiotic susceptibility patterns. ,erefore, the 91 pathogenic bacterial isolates excluding Staphylococcus
present study was carried out to investigate the bacterial profile epidermidis by the Kirby–Bauer disc diffusion method as
and their antibiogram from mobile phones and computer recommended by the Clinical and laboratory and Standards
keyboards of healthcare students at the University of Ghana, Institute [18]. ,e procedure involved the preparation of an
Korle-Bu Campus. inoculum of 0.5 McFarland turbidity standards by transfer-
ring 2 to 3 colonies of an overnight culture of the test isolate
2. Materials and Methods on MacConkey agar (Oxoid, Cambridge, UK) into a sterile
2.1. Study Area and Design. ,is was a cross-sectional study saline. A sterile cotton swab was then dipped into the 0.5
conducted on the Korle-Bu Campus of the University of McFarland standard prepared inoculum and used to inoculate
Ghana where students’ mobile phones and computers the entire surface of Mueller-Hinton agar plates (Oxoid,
(laptops and desktops) were randomly sampled from March Cambridge, UK). ,en, using a sterile forceps, the following
to June 2017. ,e Korle-Bu Campus of the University of commercially available antibiotics were placed on the streaked
Ghana is located 3 kilometers from the Accra Central Mueller-Hinton agar plate: ampicillin (10 µg), ceftazidime
Business District and houses the Central Administration of (30 µg), cefotaxime (30 µg), ciprofloxacin (5 µg), chloram-
the College of Health Sciences and the Schools of Medicine phenicol (15 µg), gentamicin (10 µg), and tetracycline (30 µg).
and Dentistry, as well as the School of Biomedical and Allied Erythromycin (15 µg) and rifampicin (5 ug) were included for
Health Sciences. Located within the same premises are the Staphylococcus aureus isolates. ,e Mueller-Hinton agar
Korle-Bu teaching hospitals, which provide healthcare plates were incubated aerobically at 37
°C for 18–24 hr. ,e
services to an estimated population of 3 million and serve as zone diameter of each of the antibiotics was measured with
a referral hospital to a population of over 25 million [16]. calipers and interpreted as per Clinical Laboratory andStandards Institute [18] recommendations. Control strains of
Pseudomonas aeruginosa ATCC 27853 and Escherichia coli
2.2. Sample Collection. A total of 240 samples were ran- ATCC 25922 were used as controls to assist in the evaluation
domly collected, and these comprised of 120 mobile phones of the performance of the test.
and 120 computer keyboards. Of the 120 mobile phones
sampled, 60 swabs were collected from students of the
School of Biomedical and Allied Health Sciences, University 2.6. Data Analysis. Data were entered into the Microsoft
of Ghana, and the other 60 swabs were from students of the excel (2010) database and analyzed descriptively with SPSS
School of Medicine and Dentistry of the University of version 20.0 (SPSS Inc., Chicago, IL). A frequency table was
Ghana. Also, of the 120 computer keyboards sampled, 10 used to display numbers, percentages of isolates, antibiotic
swabs were from the IT Lounge, 20 swabs were from the responses, and other variables. Chi square (X
2) was used for
SBAHS library, and the remaining 90 swabs were from comparison of any two categorical variables. Statistical
students’ personal laptops. Samples were collected using significance was set at a p value of <0.05.
sterile cotton swabs moistened with 0.85% sterile saline
solution and transported immediately to the SBAHS mi- 3. Results
crobiology laboratory within 2 hr for bacteriological
analysis. 3.1. Prevalence of Bacteria Isolated from Mobile Phones and
Computer Keyboards. ,e overall prevalence of bacterial
contamination on the mobile phones and computer key-
2.3. Bacteriological Analysis. In the laboratory, swabs were boards was 83.3% (100/120) and 43.3% (52/120), respec-
inoculated onto blood agar plates (Oxoid, Cambridge, UK), tively. ,ere was a significant difference between the level of
MacConkey agar plates (Oxoid, Cambridge, UK), and bacterial contamination on mobile phones and computer
Canadian Journal of Infectious Diseases and Medical Microbiology 3
keyboards (p< 0.05) (Table 1). ,e most prevalent bacteria Ethiopia, Saudi Arabia, and Italy [5, 19–23]. In contrast to
isolated from both the mobile phones and computer key- this study finding, a higher mobile phone bacterial con-
boards were Staphylococcus epidermidis (40.1% (61/150)), tamination rate of 92%–100% has been documented in
followed by Klebsiella spp. (20.4% (31/152)), Staphylococcus Slovakia, Turkey, Ethiopia, Saudi Arabia, and Ghana, re-
aureus (14.5% (22/152)), Escherichia coli (10.5% (16/152)), spectively [12, 24–27]. However, lower mobile phone bac-
Pseudomonas spp. (8.6% (13/152)), and Enterobacter cloacae terial contamination rates of 29%, 33%, 34%, 40.6%, 58.3%,
(3.3% (5/152)), and the least was Enterobacter spp. (2.6% (4/ and 62% have been reported in Jordan, Brazil, Iran, India,
152)). Libya, and Nigeria [9, 28–32]. Contrary to this study finding
Both mobile phones and computer keyboards had high that the computer keyboard bacterial contamination rate
levels of Staphylococcus epidermidis (35% and 50%) and was 43%, higher contamination rates of 76% and 99% have
Klebsiella spp. (19% and 23%) (Figure 1). While low levels of been reported in Iran and India, respectively [33, 34].
Staphylococcus aureus, Escherichia coli, and Pseudomonas However, lower bacterial contamination rates of 6.8% and
spp. was detected in both mobile phones and computer 24% have been reported in the Netherlands and the United
keyboards, Enterobacter cloacae and Enterobacter spp. were States of America, respectively [35, 36].,e varying bacterial
isolated from only mobile phones. contamination levels of mobile phones and computer
keyboards in the various countries may be attributed to
frequency of hand-washing practices and rates of cleaning
3.2. Distribution of Bacterial Isolates amongst Study Groups. mobile phones and computer keyboards [25]. In this study,
Amongst allied health students and medical students, the Staphylococcus epidermidis (25.4%), Klebsiella spp. (12.9%),
most prevalent bacteria isolated were Staphylococcus epi- and Staphylococcus aureus (9.2%) were the predominant
dermidis [16.7% (20/120) and 12.5% (15/120)], followed by bacteria isolated. Similar findings of 28.4% for Staphylo-
Klebsiella spp. [10% (12/120)] from the allied students and coccus epidermidis have been reported in Iraq [20]. Contrary
Staphylococcus aureus [8.3% (10/120)] from medical stu- to this study, a higher prevalence of 33.7% and 42.8% for
dents (Table 2). Staphylococcus epidermidis was also the Staphylococcus epidermidis have been documented in Jordan
prevalent bacteria on keyboards from students’ laptops and Nigeria [28, 37]. However, a lower prevalence of 16% and
[10% (12/120)], library [7.5% (9/120)], and IT lounges 19% have been reported in studies in Saudi Arabia and
[4.1% (5/120)], followed by Klebsiella spp. [6.7% (8/120) Nigeria [9,38]. Staphylococcus epidermidis are normal flora of
and 2.5% (3/120)] on keyboards of students’ laptops and the skin and mostly associated with low virulence [25]. ,e
library (Table 2). high occurrence of Staphylococcus epidermidis on the devices
may be due to the presence of the bacterium on the hands and
3.3. Antibiotic Susceptibility Patterns of Pathogenic Bacteria skin. Comparably, findings of 12.7% and 14.4% for Staphy-
Isolated. Ninety-one (91) pathogenic bacterial isolates were lococcus aureus have been reported in Jordan and Ethiopia
subjected to susceptibility testing. Overall, isolates showed [25, 28]. In contrast to this study, higher prevalences of 16.2%,
high level of resistance to ampicillin (96.7%) and tetracycline 20%, 30.6%, 35%, 39%, and 54.1% for Staphylococcus aureus
(75.8%), a moderate resistance to chloramphenicol (49.5%), have been reported in Saudi Arabia, Nigeria, Slovakia, Iraq,
and a lower resistance to cefotaxime (18.7%), ceftazidime Libya, and India [9, 19, 24, 27, 32, 38]. Staphylococcus aureus is
(14.2%), ciprofloxacin (25.3%), and gentamicin (24.7%) a common bacterium normally found on the skin and nasal
(Table 3). ,e resistant prevalence of the pathogenic bacteria region with an estimated 25% occurrence in healthy indi-
isolated is shown in Figure 2. viduals [39]. Staphylococcus aureus have been associated with
Out of the 91 pathogenic bacterial isolates tested, 45.1% diseases that range fromminor skin infections to more severe
expressed multidrug resistance to the different tested anti- diseases, such as pneumonia, bacteremia, septicemia, and
biotics, with Staphylococcus aureus (54.5%), Klebsiella spp. meningitis [39, 40]. Similar findings of 14.5% and 15.4% for
(29.3%), and E. coli (6.3%) showing varied levels of multi- Klebsiella spp. have been documented in Ethiopia and Nigeria
drug resistance (Table 4). In many cases, the resistance [4–10]. In contrast to this study finding, lower prevalences of
profile of the multidrug resistant isolates was highly varied 4.8%, 6.9%, 6.9%, and 3.5% have been reported in studies in
within the same isolated species. Nigeria, Iraq, Ethiopia, and Saudi Arabia [9, 12, 25, 27].
However, a higher prevalence of 33% has been reported in
4. Discussion Slovakia [24]. Klebsiella spp. is one of the major causes of
community and hospital-acquired infections, and it also has
Studies have shown that bacterial contamination of mobile the propensity to disseminate mobile genetic elements
phones, computer keyboards, and other hand-held devices [37, 41]. Similar findings of 6.5%, 5.5%, 6.8%, 8.57%, and 7.8%
may be involved in the spread of multidrug-resistant for Escherichia coli have been reported in Ethiopia, Saudi
pathogenic bacteria [1, 2, 5]. In this study, there was an Arabia, Nigeria, Libya, and Iraq [9, 20, 25, 27, 32]. Contrary to
overall bacterial contamination level of 63.3% to mobile this study, higher prevalences of 12.5% and 28.2% have been
phones and computer keyboards, and bacterial contami- documented in studies in Egypt and Nigeria [1, 10]. However,
nation of 83.3% vs. 43.3% was observed for mobile phones a lower prevalence of 2.5% has been reported in a study in
vs. computer keyboards, respectively. Similar findings of India [19]. ,e occurrence of Escherichia coli may be indic-
78.4%, 82.5%, 82.5%, 82.6%, 83.9%, and 86% have been ative of faecal contamination, probable due to minimal level
reported for mobile phones sampled in Iran, Iraq, India, of hand and mobile-phone hygienic practices. ,is bacterium
4 Canadian Journal of Infectious Diseases and Medical Microbiology
Table 1: Prevalence of bacteria isolated from mobile phones and computer keyboards.
Bacterial isolates Mobile phones Computer keyboards TotalNo. (%) No. (%) No. (%)
Staph. epidermidis 35 (29.2)∗ 26 (21.7) 61 (25.4)
Staph aureus 16 (13.3)∗ 6 (5.0) 22 (9.2)
Klebsiella spp. 19 (15.8)∗ 12 (10.0) 31 (12.9)
E. coli 13 (10.8)∗ 3(2.5) 16 (6.7)
Enterobacter spp. 4 (3.3) — 4 (1.7)
Enterobacter cloacae 5(4.2) — 5 (2.1)
Pseudomonas spp. 8 (6.7) 5 (4.2) 13 (5.4)
Total (%) 100 (83.3)∗ 52 (43.3) 152(63.3)
∗p value <0.05.
Pseudomonas spp.
Enterobacter cloacae
Enterobacter spp.
Escherichia coli
Klebsiella spp.
Staphylococcus aureus
Staphylococcus epidermidis
0 10 20 30 40 50 60
Prevalence (%)
Computer keyboards
Mobile phones
Figure 1: Prevalence of bacteria isolated from mobile phones and computer keyboards.
Table 2: Distribution of bacteria isolates amongst study areas.
Mobile phones n� 120 Computer keyboards n� 120
Bacteria isolated AHS (%) MEDS (%) STL (%) L (%) ITL (%)
Total (%)
(n� 60) (n� 60) (n� 90) (n� 20) (n� 10)
Staphylococcus epidermidis 20(33.3) 15(25) 12 (13.3) 9(45) 5(50) 61 (25.4)
Staphylococcus aureus 6 (10) 10(16.7) 4(4.4) 1(5) 1(10) 22 (9.2)
Klebsiella spp. 12(20) 7(11.7) 8(8.9) 3(15) 1(10) 31 (12.9)
Escherichia coli 8(13.3) 5(8.3) 2 (2.2) 1 (5) 0 16 (6.7)
Enterobacter spp. 3(5) 1(1.7) 0 0 0 4 (1.7)
Enterobacter cloacae 2(3.3) 3 (5) 0 0 0 5 (2.1)
Pseudomonas spp. 5(8.3) 3 (5) 5 (5.6) 0 0 13 (5.4)
AHS: allied health students, MEDS: medical students, STL: student laptop, L: library, ITL: IT lounge.
Table 3: Antibiotic susceptibility patterns of pathogenic bacteria isolated.
Staphylococcus Klebsiella Escherichia Enterobacter Enterobacter Pseudomonas
aureus spp. coli spp. cloacae aeruginosa TotalAntibiotics n� 22 n� 31 n� 16 n� 4 n� 5 n� 13 n� 91
No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. t(%)
AMP 22 (100) 30 (96.7) 15 (93.8) 4 (100) 4 (80.0) 13 (100) 88 (96.7)
CTX 5 (22.7) 3 (9.7) 4 (25) 1 (25.0) 1 (20.0) 3 (23.1) 17 (18.7)
CAZ 3 (13.8) 2 (6.5) 3 (18.6) 0 (0.0) 0 (0.0) 5 (38.5) 13 (14.2)
CIP 10 (45.4) 5 (16.1) 3 (18.6) 1 (25) 2 (40.0) 2 (15.4) 23 (25.3)
CHL 6 (27.7) 17 (54.9) 12 (75.0) 3 (75.0) 3 (60.0) 4 (30.9) 45 (49.5)
ERY 7 (31.8) — — — — — —
GEN 5 (22.7) 6 (19.4) 5 (31.3) 2 (50.0) 2 (40.0) 2 (15.4) 22 (24.7)
TET 9 (40.9) 25 (80.6) 10 (62.5) 3 (75.0) 3 (60.0) 8 (61.5) 69 (75.8)
RIF 2 (9.1) — — — — — —
AMP- ampicillin, CTX- cefotaxime, CAZ- ceftazidime, CIP- ciprofloxacin, CHL- chloramphenicol, ERY- erythromycin, GEN- gentamicin, TET- tetracycline,
RIF- rifampicin.
Bacterial isolates
Canadian Journal of Infectious Diseases and Medical Microbiology 5
120
100
80
60
40
20
0
AMP CTX CAZ CIP CHL ERY GEN TET RIF
Antibiotics
Staphylococcus aureus Enterobacter spp.
Klebsiella spp. Enterobacter cloacae
Escherichia coli Pseudomonas spp.
Figure 2: Resistance patterns of pathogenic bacteria isolated.
Table 4: Prevalence of multidrug resistance among different bacterial isolates.
Bacteria No. of isolates Multidrug-resistance patterns
3 AMP-CTX-CAZ-CIP-CHL-ERY-GEN-TET-RIF
2 AMP-CTX-CIP-CHL-ERY-GEN-TET-RIF
Staphylococcus aureus 2 AMP-CTX-CIP-CHL-ERY-TET-RIF1 AMP-CIP-CHL-ERY-TET
1 AMP-CIP-ERY-TET
3 AMP-CIP-TET
3 AMP-CTX-CAZ-CIP-CHL-GEN-TET
Klebsiella spp. 2 AMP-CTX-CIP-CHL-GEN-TET1 AMP-CIP-CHL-TET
3 AMP-CIP-TET
3 AMP-CTX-CAZ-CIP-CHL-GEN-TET
Escherichia coli 1 AMP-CTX-CHL-GEN-TET1 AMP-CHL-GEN-TET
5 AMP-CHL-TET
1 AMP-CTX-CIP-CHL-GEN-TET
Enterobacter spp. 1 AMP-CHL-GEN-TET
1 AMP-CHL-TET
1 AMP-CTX-CIP-CHL-GEN-TET
Enterobacter cloacae 1 AMP-CIP-CHL-GEN-TET
1 AMP-CHL-TET
2 AMP-CTX-CAZ-CIP-CHL-GEN-TET
Pseudomonas spp. 1 AMP-CTX-CAZ-CHL-GEN-TET
1 AMP-CHL-TET
AMP- ampicillin, CTX- cefotaxime, CAZ- ceftazidime, CIP- ciprofloxacin, CHL- chloramphenicol, ERY- erythromycin, GEN- gentamicin, TET- tetracycline,
RIF- rifampicin.
is one of the most common etiological agents of diarrhoea, Staphylococcus aureus was 100% resistant to ampicillin.
neonatal septicemia, urinary tract infections, bacteremia, and Comparable findings of 100% and 61.1% resistance to
urosepsis [42]. It accounts for 80% of community-acquired ampicillin have been reported in studies carried out in
urinary tract infections as well as 30% of nosocomial in- Nepal and Ethiopia [25, 46]. Staphylococcus aureus was
fections [43]. Presently, antibiotic-resistant bacteria have 45.4% resistant to ciprofloxacin. A comparable resistant
become a global public health issue to such an extent that it prevalence of 40.9% has been documented in a study in
has led to high morbidity and mortality, long hospital stays, Bangladesh [47]. In contrast to this study’s findings, lower
and higher treatment expenses [44, 45]. In this study, resistance prevalences of 6.6%, 8.3%, 14.3%, and 19.3% have
Resistance profile (%)
6 Canadian Journal of Infectious Diseases and Medical Microbiology
been documented in studies carried out in Nigeria, Rwanda, these devises being vehicles for the transmission of antibi-
Iran, and Ethiopia [10, 25, 48, 49]. However, a higher resistant otic-resistant bacterial strains. To a greater extent, this will
prevalence of 87.5% has been reported in a study carried out assist to disseminate information on resistant patterns of
in Ethiopia [44]. Staphylococcus aureus was 22.7% resistant to some multidrug-resistant bacteria pathogens. ,e study
gentamicin. Similar findings of 22.6% resistance to Staphylo- focused on bacterial contamination of mobile phones and
coccus aureus have been reported in a study performed in computer keyboards with its associated resistant patterns.
Ethiopia [25]. In contrast to this study, a higher resistant Decontamination of mobile phones and computer key-
prevalence of 40.9% has been reported in a study conducted in boards with 70% alcohol was not carried out to assess the
Bangladesh [47]. However, a lower resistant prevalence of 15%, contamination level after decontamination.
12.1%, and 3.6% have been observed in studies conducted in
Nepal, Nigeria, and Iran [10, 46, 49]. Staphylococcus aureuswas Data Availability
31.8% resistant to erythromycin. Comparable resistant prev-
alences of 23.2%, 36.4%, and 39.4% have been revealed in ,e datasets used are available on reasonable demand.
studies performed in Iran, Bangladesh, and Nigeria [9, 47, 49].
In contrast to this study finding, a higher resistant prevalence of Ethical Approval
75% has been reported in a study carried out in Nepal [46]. In
this study, Klebsiella spp. and Escherichia coli were 96.7% vs. Ethical clearance was sought from the Ethical Review
93.8% resistant to ampicillin. Comparable findings of 95% vs. Committee of the School of Biomedical and Allied Health
100% forKlebsiella spp. and Escherichia coli have been reported Sciences, ethics identification no. SBAHS–MD./10468330/
in Ethiopia [5]. However, in contrast to this study finding, AA/5A/2016–2017. Formal approval was also obtained from
lower resistance prevalences of 20% vs. 10.5% have been re- the Heads of the aforementioned ICTunits and students who
ported in Rwanda [48]. In this study, Klebsiella spp. and participated in the study before sample collection.
Escherichia coli were 19.4% vs. 31.3% resistant to gentamicin.
Similar findings of 14% vs. 33% resistance prevalences have Conflicts of Interest
been documented in a study carried out in Ethiopia [5].
Contrary to these findings, higher resistant prevalences of ,e authors declare that no conflicts of interest exist.
83.3% vs. 72.7% were reported in a study conducted in Nigeria
[9]. In this study, Klebsiella spp. and Escherichia were 16.1% Acknowledgments
vs. 18.6% resistant to ciprofloxacin. Comparable findings of
13.3% vs. 31.6%, 8.1% vs. 19.1%, and 33% vs. 0% forKlebsiella ,e authors would like to express their gratitude to all the
spp. and Escherichia coli have been documented in studies University students who volunteered to take part in this
from Rwanda, Nigeria, and Ethiopia [5, 10, 48]. ,e varying study.
resistance prevalence may be due to different geographic
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