{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:51Z","timestamp":1787028351621,"version":"build-2736575974"},"reference-count":26,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UK Department of Health and Social Care"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Nasopharyngeal carriage of aerobic Gram-negative bacilli (GNB) may precede the development of invasive respiratory infections. We assessed the prevalence of nasopharyngeal carriage of aerobic GNB and their antimicrobial resistance patterns among healthy under-five children attending seven selected day-care centres in the Accra metropolis of the Greater Accra region of Ghana from September to December 2016. This cross-sectional study analysed a total of 410 frozen nasopharyngeal samples for GNB and antimicrobial drug resistance. The GNB prevalence was 13.9% (95% CI: 10.8\u201317.6%). The most common GNB were Escherichia coli (26.3%), Klebsiella pneumoniae (24.6%), and Enterobacter cloacae (17.5%). Resistance was most frequent for cefuroxime (73.7%), ampicillin (64.9%), and amoxicillin\/clavulanic acid (59.6%). The organisms were least resistant to gentamicin (7.0%), amikacin (8.8%), and meropenem (8.8%). Multidrug resistance (MDR, being resistant to \u22653 classes of antibiotics) was observed in 66.7% (95% CI: 53.3\u201377.8%). Extended-spectrum beta-lactamase (ESBL)-producing bacteria constituted 17.5% (95% CI: 9.5\u201329.9%), AmpC-producing bacteria constituted 42.1% (95% CI: 29.8\u201355.5%), and carbapenemase-producing bacteria constituted 10.5% (95% CI: 4.7\u201321.8%) of isolates. The high levels of MDR are of great concern. These findings are useful in informing the choice of antibiotics in empiric treatment of GNB infections and call for improved infection control in day-care centres to prevent further transmission.<\/jats:p>","DOI":"10.3390\/ijerph191710927","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T21:27:17Z","timestamp":1662067637000},"page":"10927","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Alarming Levels of Multidrug Resistance in Aerobic Gram-Negative Bacilli Isolated from the Nasopharynx of Healthy Under-Five Children in Accra, Ghana"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2216-7237","authenticated-orcid":false,"given":"Mary-Magdalene","family":"Osei","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana"},{"name":"FleRhoLife Research Consult, Accra P.O. Box TS 853, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4491-6902","authenticated-orcid":false,"given":"Nicholas T. K. D.","family":"Dayie","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godfred S. K.","family":"Azaglo","sequence":"additional","affiliation":[{"name":"Environmental Protection Agency, Starlet 91 Road, Ministries, Accra P.O. Box MB 326, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth Y.","family":"Tettey","sequence":"additional","affiliation":[{"name":"Korle-Bu Teaching Hospital, Guggisberg Avenue, Accra P.O. Box 77, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund T.","family":"Nartey","sequence":"additional","affiliation":[{"name":"Centre for Tropical Clinical Pharmacology & Therapeutics, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9367-1265","authenticated-orcid":false,"given":"Ama P.","family":"Fenny","sequence":"additional","affiliation":[{"name":"Institute of Statistical, Social and Economic Research (ISSER), University of Ghana, Accra P.O. Box LG 25, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2346-5137","authenticated-orcid":false,"given":"Marcel","family":"Manzi","sequence":"additional","affiliation":[{"name":"Department of Medical OCB, MSF-Belgium Headquarters, Rue de Bomel 65, 5000 Namur, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1011-8531","authenticated-orcid":false,"given":"Ajay M. V.","family":"Kumar","sequence":"additional","affiliation":[{"name":"International Union Against Tuberculosis and Lung Disease, 2 Rue Jean Lantier, 75001 Paris, France"},{"name":"International Union Against Tuberculosis and Lung Disease, South-East Asia Office, C-6 Qutub Institutional Area, New Delhi 110016, India"},{"name":"Yenepoya Medical College, Yenepoya (Deemed to Be University) University, University Road, Deralakatte, Mangalore 575018, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Appiah-Korang","family":"Labi","sequence":"additional","affiliation":[{"name":"World Health Organization Country Office, Roman Ridge, Accra P.O. Box MB 142, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Japheth A.","family":"Opintan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Sampane-Donkor","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Ghana Medical School, Accra P.O. 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