{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:29:00Z","timestamp":1777922940395,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>\n                    In Ghana, surveillance efforts on antibiotic resistance so far have not covered carbapenem resistance. In this study, our aim was to apply phenotypic and genotypic methods to identify and characterize carbapenem-resistant (CR) Gram-negative bacteria from the hospital environment in Ghana. A collection of 3840 isolates of Gram-negative bacilli infections from various clinical specimens was screened for carbapenem resistance by disc diffusion for imipenem, meropenem, and doripenem. Minimum Inhibitory Concentration (MIC) of the CR isolates was determined by E-test for the three carbapenems. All the CR isolates were further screened for carbapenemase activity by modified Hodge and boronic acid disc synergy tests. The CR isolates were investigated for the presence of carbapenemase and extended-spectrum beta-lactamase genes by PCR and confirmed by sequencing. The overall prevalence of CR isolates was 2.9% (111\/3840). Based on the disc diffusion test, prevalence of resistance to carbapenems were doripenem (75%), imipenem (66.7%), and meropenem (58%). The highest measurable MIC levels (\u226532\u2009\u03bcg\/mL) were observed in 56.8% of CR isolates with the nonfermenters,\n                    <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                    (24.3%) and\n                    <jats:italic toggle=\"yes\">Acinetobacter<\/jats:italic>\n                    species (18.9%), disproportionately represented. Phenotypic identification of carbapenamase activity occurred in 18.9% of the CR isolates by the modified Hodge test and 2.7% by Boronic acid disc synergy test; 21.6% exhibited carbapenemase production by both methods. All the CR isolates carried ESBL genes (\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    TEM and\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    SHV), whereas 23.4% were carriers of carbapenemase genes, of which 14.4% were\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    NDM-1, 7.2%\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    VIM-1, and 1.8%\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    OXA-48. Phylogenetically, the CR isolates were diverse and showed limited relatedness to isolates from other geographical regions.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2018.0278","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T10:29:54Z","timestamp":1561458594000},"page":"1449-1457","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":33,"title":["Phenotypic and Genotypic Characterization of Carbapenem-Resistant Gram-Negative Bacilli Pathogens from Hospitals in Ghana"],"prefix":"10.1177","volume":"25","author":[{"given":"Francis S.","family":"Codjoe","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Sciences, School of Biomedical &amp; Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana."},{"name":"Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric S.","family":"Donkor","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Biomedical &amp; Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas J.","family":"Smith","sequence":"additional","affiliation":[{"name":"Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Miller","sequence":"additional","affiliation":[{"name":"Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1710.110655"},{"key":"e_1_3_4_3_2","first-page":"239","article-title":"The emergence of carbapenem resistance in Enterobacteriaceae in South Africa","volume":"26","author":"Coetzee J.","year":"2011","unstructured":"Coetzee J., , and Brink A. 2011. The emergence of carbapenem resistance in Enterobacteriaceae in South Africa. South Afr. J. Epidemiol. Infect. 26:239\u2013240.","journal-title":"South Afr. J. Epidemiol. Infect"},{"key":"e_1_3_4_4_2","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1128\/AAC.01247-10","article-title":"Detection of NDM-1-Producing Klebsiella pneumoniae in Kenya","volume":"55","author":"Poirel L.","year":"2011","unstructured":"Poirel L., , Gunturu R., , Bernabeu S., , and Nordmann P. 2011. Detection of NDM-1-Producing Klebsiella pneumoniae in Kenya. Antimicrob. Agents Chemother. 55:934\u2013936.","journal-title":"Antimicrob. 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Outbreak of OXA-48-positive carbapenem-resistant Klebsiella pneumoniae isolates in France. Antimicrob. Agents Chemother. 55:2420\u20132423."},{"key":"e_1_3_4_33_2","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1099\/jmm.0.028308-0","article-title":"Detection of an Ambler class D OXA-48-type beta-lactamase in a Klebsiella pneumoniae strain in The Netherlands","volume":"60","author":"Kalpoe J.S.","year":"2011","unstructured":"Kalpoe J.S., , Al Naiemi N., , Poirel L., , and Nordmann P. 2011. Detection of an Ambler class D OXA-48-type beta-lactamase in a Klebsiella pneumoniae strain in The Netherlands. J. Med. Microbiol. 60:677\u2013678.","journal-title":"J. Med. Microbiol"},{"key":"e_1_3_4_34_2","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1080\/21505594.2016.1222343","article-title":"The global epidemiology of carbapenemase-producing Enterobacteriaceae","volume":"8","author":"Doi Y.","year":"2017","unstructured":"van Duin and Doi Y. 2017. The global epidemiology of carbapenemase-producing Enterobacteriaceae. Virulence. 8:460\u2013469.","journal-title":"Virulence"},{"key":"e_1_3_4_35_2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.3201\/eid1701.100244","article-title":"Class D OXA-48 carbapenemase in multidrug-resistant enterobacteria, Senegal","volume":"17","author":"Moquet O.","year":"2011","unstructured":"Moquet O., , Bouchiat C., , Kinana A., , Seck A., , Arouna O., , Bercion R., , Breurec S., , and Garin B. 2011. Class D OXA-48 carbapenemase in multidrug-resistant enterobacteria, Senegal. Emerg. Infect. Dis. 17:143\u2013144.","journal-title":"Emerg. Infect. Dis"},{"key":"e_1_3_4_36_2","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1128\/JCM.02771-15","article-title":"The problem of carbapenemase-producing-carbapenem-resistant-Enterobacteriaceae detection","volume":"54","author":"Limbago B.M.","year":"2016","unstructured":"Lutgring, J.D. and Limbago B.M. 2016. The problem of carbapenemase-producing-carbapenem-resistant-Enterobacteriaceae detection. J. Clin. Microbiol. 54:529\u2013534.","journal-title":"J. Clin. 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