{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:11:24Z","timestamp":1790813484815,"version":"4.1.0"},"reference-count":70,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Carbapenem-resistant Enterobacteriaceae (CRE) and Extended-spectrum beta-lactamase (ESBL) production among Gram-negative Enterobacteriaceae is an increasing global challenge due to the high morbidity and mortality associated with their infections, especially in developing countries where there are little antibiotic treatment options. Despite these challenges, few studies in Ghana have described the burden of CRE. Therefore, this study aimed to determine the prevalence of carbapenem-resistant Enterobacteriaceae isolated from patients at the Cape Coast Teaching Hospital (CCTH) in the Central region of Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal findings<\/jats:title>\n                    <jats:p>\n                      Enterobacteriaceae isolates were collected from April to July 2019 at the bacteriology unit of CCTH using a consecutive sampling method. Isolates were identified by standard microbiological techniques and confirmed using API 20E. Kirby Bauer disc diffusion method was used to determine the antibiogram of isolates. Isolates were also subjected to ESBL testing using the single-disc combination method. Carbapenem-resistant isolates were identified by the Kirby Bauer disc diffusion method and then examined genotypically for the presence of\n                      <jats:italic>blaKPC-1<\/jats:italic>\n                      ,\n                      <jats:italic>blaIMP-1<\/jats:italic>\n                      ,\n                      <jats:italic>blaVIM-1<\/jats:italic>\n                      ,\n                      <jats:italic>blaNDM-1<\/jats:italic>\n                      , and\n                      <jats:italic>blaOXA-48<\/jats:italic>\n                      genes via polymerase chain reaction (PCR). Of the 230 isolates comprising\n                      <jats:italic>E<\/jats:italic>\n                      .\n                      <jats:italic>coli<\/jats:italic>\n                      (40.9%),\n                      <jats:italic>Citrobacter spp<\/jats:italic>\n                      . (32.6%),\n                      <jats:italic>K<\/jats:italic>\n                      .\n                      <jats:italic>pneumoniae<\/jats:italic>\n                      (9.1%),\n                      <jats:italic>P<\/jats:italic>\n                      .\n                      <jats:italic>mirabilis<\/jats:italic>\n                      (6.1%),\n                      <jats:italic>P<\/jats:italic>\n                      .\n                      <jats:italic>vulgaris<\/jats:italic>\n                      (5.2%),\n                      <jats:italic>Enterobacter spp<\/jats:italic>\n                      (3.5%).,\n                      <jats:italic>K<\/jats:italic>\n                      .\n                      <jats:italic>oxytoca<\/jats:italic>\n                      (2.2%), and\n                      <jats:italic>Serratia marcenses<\/jats:italic>\n                      (0.4%). Most isolates were from urine 162(70.4%) and wound samples. The isolates showed high resistance to ampicillin 171 (74.3%) and cefuroxime 134(58.3%). The prevalence of MDR was 35.2% (81), with\n                      <jats:italic>E<\/jats:italic>\n                      .\n                      <jats:italic>coli<\/jats:italic>\n                      40(42.6%) being the majority that exhibited MDR. Of the 230 isolates, 113(49.1%) were ESBL producers, with\n                      <jats:italic>E<\/jats:italic>\n                      .\n                      <jats:italic>coli<\/jats:italic>\n                      54(57.5%) accounting for the majority, while\n                      <jats:italic>Serratia marcenses<\/jats:italic>\n                      was the least. Of the 13 (5.7%) CRE isolates that showed resistance towards carbapenem in the disc diffusion method, 11 showed the presence of the\n                      <jats:italic>blaNDM-1<\/jats:italic>\n                      gene, while all isolates showed the presence of the\n                      <jats:italic>blaOXA-48<\/jats:italic>\n                      gene.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prevalence of carbapenem resistance and ESBL-producing Enterobacteriaceae pathogens among patients at the Cape Coast Teaching Hospital is high and alarming. Therefore, it is imperative to consider effective infection prevention and control measures should be implemented at the hospital to prevent the rapid spread of these dangerous organisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0274156","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T13:41:56Z","timestamp":1698673316000},"page":"e0274156","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":21,"title":["Prevalence of carbapenem-resistant and extended-spectrum beta-lactamase-producing Enterobacteriaceae in a teaching hospital in Ghana"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9456-9067","authenticated-orcid":true,"given":"James","family":"Sampah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1185-3514","authenticated-orcid":true,"given":"Isaac","family":"Owusu-Frimpong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank Twum","family":"Aboagye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Owusu-Ofori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"pone.0274156.ref001","author":"World Health Organization","year":"2014","journal-title":"Antimicrobial resistance:: Global report on surveillance"},{"key":"pone.0274156.ref002","year":"2018","journal-title":"World Health Organization 2018 Global Antimicrobial Resistance Surveillance System (GLASS) Report Early Implementation 2017\u20132018"},{"key":"pone.0274156.ref003","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.cmi.2017.02.034","article-title":"Control of multidrug-resistant Gram-negative bacteria in low- and middle-income countries-high impact interventions without much resources","volume":"23","author":"N Singh","year":"2017","journal-title":"Clin Microbiol Infect"},{"key":"pone.0274156.ref004","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s13756-018-0324-2","article-title":"Multidrug-resistant gram-negative bacterial infections in a teaching hospital in Ghana.","volume":"7","author":"N Agyepong","year":"2018","journal-title":"Antimicrob Resist Infect Control"},{"key":"pone.0274156.ref005","volume-title":"Microbial pathogens and strategies for combating them: Science, technology and education","author":"A. 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