Prevalence of the Proteus species causing infections at the Komfo Anokye Teaching Hospital (KATH) and their antimicrobial resistance
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Date
2009-08-23
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Abstract
Various Proteus species are known to be responsible for causing several human infections. The various species may also present with different antimicrobial susceptibility patterns. However, in most of our hospitals, differentiation of the genus Proteus into species is not fully practised during bacteriological diagnosis because more materials, time and labour are required to carry out such tests. As a result, there is scanty information on the different types of Proteus species and how they vary with the types of infections they cause both in our communities and hospital environments. The level of resistance of the Proteus species to the commonly tested antimicrobial agents is also not known. This study therefore seeks to determine the prevalence of the various Proteus species causing infections and their antimicrobial susceptibility patterns at KATH. From 25th November, 2006 to 20th July, 2007, a total of two hundred (200) Proteus species were isolated from 2369 clinical specimens of patients suspected of bacterial infections. Three different Proteus species were identified and their antimicrobial resistant patterns determined. The Proteus isolates were also related to the patient's demographic data. Proteus mirabilis (61.5%) was identified as the commonest species causing the majority of Proteus infections followed by Proteus vulgaris (30.5%), with Proteus penneri (8%) being the least isolated species. The infection was distributed evenly among the sexes. The most susceptible age group to Proteus infections was the 1-9 age group. Blocks D (medical unit), B (childrens block) and C (accident/surgical unit) were identified as the most Proteus infection prone blocks at KATH. Antimicrbial susceptibility pattern of the Proteus species revealed that they were highly resistant to the antimicrobial agents tested with the following resistance values to ampicillin (77%), tetracycline (85%), chloramphenicol (82.5%) and co-trimoxazole (81%). Their levels were low with resistance levels to amikacin being 4%, gentamicin (26.5%), ceftriaxone (36.5%) and cefotaxime (38%). Amikacin and gentamicin were therefore the most potent drugs with resistance levels being 4% and 26.5% respectively, Beta-lactamase was detected among the Proteus species with the highest beta-lactamase producing species being Proteus mirabilis (77%), followed by Proteuspenneri (75%), with the least being Proteus vulgaris (64.5%). It is recommended that there should be continuous surveillance on antimicrobial resistance of bacterial isolates which should be identified to the species level in our hospitals. Information from these surveillances should be stored (on computers) to form a data base in the hospitals for health planners and quick reference guide for clinicians who prescribe antibiotics emperically and also for researchers.
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A thesis submitted to the College of Health Sciences, 2009