{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T13:09:39Z","timestamp":1793884179315,"version":"4.7.0"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"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>Vulnerable groups, such as pregnant women, are at increased risk of potentially life-threatening infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) for both mother and newborn. However, data regarding ESBL-E carriage and associated risk factors in Ghanaian pregnant women remain scarce.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This study aimed to determine the prevalence of ESBL-E carriage and its associated risk factors among pregnant women attending the antenatal clinic at the Korle Bu Teaching Hospital.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A systematic sample of 700 pregnant women with gestational age \u2265 34 weeks attending the antenatal clinic at Korle Bu Teaching Hospital was included in the study. After administering a structured questionnaire to assess potential risk factors associated with ESBL-E carriage, patients were given a sterile stool container to submit at least 1 g of stool specimen. Recovered isolates from faecal specimens were identified using MALDI-TOF-MS technology. These isolates were then subjected to susceptibility testing and ESBL identification. A random subset of 24 ESBL-producing <jats:italic>Escherichia coli<\/jats:italic> isolates was whole-genome sequenced on the MiSeq Illumina platform. Risk factors associated with ESBL-E carriage were determined using multivariable logistic regression analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among the 700 pregnant women, 42% (294) carried ESBL-E. The predominant ESBL-producing Enterobacterales were <jats:italic>Escherichia coli<\/jats:italic> (95%). Fifty percent (50%) of ESBL-E were multidrug resistant isolates (MDRs). Whole-genome sequencing of 24 ESBL-producing E. coli isolates revealed that blaCTX-M-15 (96%) was the most prevalent ESBL gene type. Notably, most isolates belonged to commensal phylogenetic groups (A, B1, and C; 88%). Having a primary level of education (aOR 1.45, 95% CI 1.05\u20131.96) and consuming legumes as the main source of protein (aOR 0.17, 0.40\u20130.83) were significantly associated with intestinal carriage of ESBL-E.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study identified a high prevalence of ESBL-E and MDR-ESBL-E carriage among pregnant women. Our findings underscore the urgent need for public health interventions to control the spread of AMR.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0310058","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T18:27:47Z","timestamp":1731349667000},"page":"e0310058","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana"],"prefix":"10.1371","volume":"19","author":[{"given":"Noah","family":"Obeng-Nkrumah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Appiah","family":"Korang-Labi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kwao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Egyir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Nuertey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3147-5143","authenticated-orcid":true,"given":"George","family":"Hedidor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gifty","family":"Boateng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwaku","family":"Asah-Opoku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Dankwah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Okine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3928-2116","authenticated-orcid":true,"given":"Japheth A.","family":"Opintan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"pone.0310058.ref001","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1093\/jac\/dkn293","article-title":"Faecal carriage of extended-spectrum \u03b2-lactamase-producing Escherichia coli: prevalence, risk factors and molecular epidemiology","volume":"62","author":"J Rodr\u00edguez-Ba\u00f1o","year":"2008","journal-title":"Journal of Antimicrobial Chemotherapy"},{"key":"pone.0310058.ref002","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1128\/CMR.14.4.933-951.2001","article-title":"Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat","volume":"14","author":"PA Bradford","year":"2001","journal-title":"Clin Microbiol Rev"},{"key":"pone.0310058.ref003","first-page":"11","article-title":"Extended Spectrum Beta-lactamases: Definition, Classification and Epidemiology","volume":"17","author":"S Ghafourian","year":"2015","journal-title":"Current Issues in Molecular Biology"},{"key":"pone.0310058.ref004","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1093\/cid\/ciq257","article-title":"International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases","volume":"52","author":"K Gupta","year":"2011","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0310058.ref005","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1128\/CMR.00023-13","article-title":"Trends in Human Fecal Carriage of Extended-Spectrum \u03b2-Lactamases in the Community: Toward the Globalization of CTX-M","volume":"26","author":"P-L Woerther","year":"2013","journal-title":"Clin Microbiol Rev"},{"key":"pone.0310058.ref006","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.ijid.2017.08.015","article-title":"Maternal colonization or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in Africa: A systematic review and meta-analysis","volume":"64","author":"ANH Bulabula","year":"2017","journal-title":"International Journal of Infectious Diseases"},{"key":"pone.0310058.ref007","doi-asserted-by":"crossref","first-page":"572","DOI":"10.3390\/antibiotics10050572","article-title":"Maternal Vaginal Colonization and Extended-Spectrum Beta-Lactamase-Producing Bacteria in Vietnamese Pregnant Women","volume":"10","author":"NT Viet","year":"2021","journal-title":"Antibiotics (Basel)"},{"key":"pone.0310058.ref008","unstructured":"Thenmozhi S, Moorthy K, Sureshkumar BT, Suresh M. 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