{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:18:21Z","timestamp":1791249501953,"version":"4.1.0"},"reference-count":22,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,11,6]]},"abstract":"<jats:p>\n                    Infections with bacteria producing extended-spectrum beta-lactamases (ESBLs) are increasing across Africa. This study reports on ESBL-producing\n                    <jats:italic>Enterobacteriaceae<\/jats:italic>\n                    as significant causes of infections and antibiotic resistance at Korle-Bu Teaching Hospital in Accra, Ghana. Of 300 isolates examined, 49.3% produced ESBLs. The prevalence of ESBLs was significantly high among isolates from neonates (28 of 43, 65.1%; relative risk = 1.62, 95% confidence interval = 1.33\u20132.13,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.002) and adult patients &gt; 65 years of age (36 of 51, 70.5%; relative risk = 1.89, 95% confidence interval = 1.41\u20132.40,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.001). A marked increase in minimum inhibitory concentrations of ESBL-positive species was noticed compared with those for the other strains. Using these concentrations, we found that 26 (17%) ESBL producers were resistant to two or more antibiotics (aminoglycosides, fluoroquinolones, sulfonamide, and carbapenems) whereas 5 (3.2%) non\u2013ESBL producers were multidrug resistant. Regular ESBL detection and evaluation of antibiotic resistance may help reduce the spread of ESBLs and antibiotic resistance in Ghana.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.12-0642","type":"journal-article","created":{"date-parts":[[2013,9,17]],"date-time":"2013-09-17T00:35:59Z","timestamp":1379378159000},"page":"960-964","source":"Crossref","is-referenced-by-count":100,"title":["High Levels of Extended-Spectrum Beta-Lactamases in a Major Teaching Hospital in Ghana: The Need for Regular Monitoring and Evaluation of Antibiotic Resistance"],"prefix":"10.4269","volume":"89","author":[{"given":"Noah","family":"Obeng-Nkrumah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kingsley","family":"Twum-Danso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A.","family":"Krogfelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercy J.","family":"Newman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Curr Opin Microbiol","first-page":"525","article-title":"\u03b2-lactam antibiotic resistance: a current structural perspective","volume":"8","author":"Wilke","year":"2005"},{"key":"R2","series-title":"N Engl J Med","first-page":"380","article-title":"The new \u03b2-lactamases","volume":"352","author":"Jacoby","year":"2005"},{"key":"R3","series-title":"Curr Pharm Des","first-page":"250","article-title":"Detection of gram-negative \u03b2-lactamase producing pathogens in the clinical lab","volume":"19","author":"Thomson","year":"2013"},{"key":"R4","series-title":"Clin Infect Dis","first-page":"1030","article-title":"The public health risks of enterobacterial isolates producing extended-spectrum \u03b2-lactamases (ESBL) or AmpC \u03b2-lactamases in food and food-producing animals: an EU perspective of epidemiology, analytical methods, risk factors and control options","volume":"56","author":"Liebana","year":"2013"},{"key":"R5","series-title":"Expert Rev Anti Infect Ther","first-page":"1269","article-title":"Global antimicrobial resistance: from surveillance to stewardship. Part 1: surveillance and risk factors for resistance","volume":"10","author":"Cant\u00f3n","year":"2012"},{"key":"R6","series-title":"J Microbiol Immunol Infect","article-title":"Risk factors and clinical impact of levofloxacin or cefazolin nonsusceptibility or ESBL production among uropathogens in adults with community-onset urinary tract infections","author":"Yi-Hui","year":"2012"},{"key":"R7","series-title":"Antimicrob Agents Chemother","first-page":"88","article-title":"Complexity and diversity of Klebsiella pneumoniae strains with extended-spectrum \u03b2-lactamases isolated in 1994 and 1996 at a teaching hospital in Durban, South Africa","volume":"45","author":"Essack","year":"2001"},{"key":"R8","series-title":"Diagn Microbiol Infect Dis","first-page":"193","article-title":"Prevalence of extended-spectrum \u03b2-lactamase (ESBL)-producing clinical isolates in the Asia-Pacific region and South Africa: regional results from SENTRY Antimicrobial Surveillance Program (1998 to 99)","volume":"42","author":"Bell","year":"2002"},{"key":"R9","series-title":"J Med Microbiol","first-page":"162","article-title":"Molecular characterization of extended-spectrum \u03b2-lactamase-producing Shigella isolates from humans in South Africa, 2003\u20132009","volume":"61","author":"Tau","year":"2012"},{"key":"R10","series-title":"Int J Antimicrob Agents","first-page":"119","article-title":"Determining incidence of extended-spectrum \u03b2-lactamase-producing Enterobacteriaceae, vancomycin-resistant Enterococcus faecium and methicillin-resistant Staphylococcus aureus in 38 centres from 17 countries: the PEARLS study 2001 to 2002","volume":"24","author":"Bouchillon","year":"2004"},{"key":"R11","series-title":"BMC Infect Dis","first-page":"84","article-title":"Characterization of CTX-M ESBLs in Enterobacter cloacae, Escherichia coli and Klebsiella pneumoniae clinical isolates from Cairo, Egypt","volume":"9","author":"Khalaf","year":"2009"},{"key":"R12","series-title":"Microb Drug Resist","first-page":"132","article-title":"Involvement of SHV-12 and SHV-2a encoding plasmids in outbreaks of extended-spectrum \u03b2-lactamase-producing Klebsiella pneumoniae in a Tunisian neonatal ward","volume":"10","author":"Ben-Hamouda","year":"2004"},{"key":"R13","series-title":"J Antimicrob Chemother","first-page":"169","article-title":"Plasmid-mediated TEM-3 extended-spectrum \u03b2-lactamase-production in Salmonella typhimurium in Casablanca","volume":"49","author":"Aitmhand","year":"2002"},{"key":"R14","series-title":"J Clin Microbiol","first-page":"745","article-title":"High rate of fatal cases of pediatric septicemia caused by gram-negative bacteria with extended-spectrum \u03b2-lactamases in Dar es Salaam, Tanzania","volume":"43","author":"Blomberg","year":"2005"},{"key":"R15","series-title":"Clin Microbiol Infect","first-page":"E49","article-title":"Sequence type ST131 and ST10 complex (ST617) predominant among CTX-M-15-producing Escherichia coli isolates from Nigeria","volume":"18","author":"Aibinu","year":"2012"},{"key":"R16","series-title":"Cowans and Steels Manual for Identification of Medical Bacteria","first-page":"94","article-title":"Characteristics of gram negative bacteria","author":"Cowan","year":"2004"},{"key":"R17","article-title":"Performance standards for antimicrobial susceptibility testing, 17th informational supplement","author":"Clinical and Laboratory Standards Institute (CLSI)","year":"2007"},{"key":"R18","article-title":"Methods for dilution antimicrobial susceptibility test for bacteria that grow aerobically","author":"Clinical and Laboratory Standards Institute (CLSI)","year":"2006"},{"key":"R19","series-title":"Diagn Microbiol Infect Dis","first-page":"62","article-title":"Antimicrobial susceptibility of Enterobacteriaceae, including molecular characterization of extended-spectrum beta-lactamase-producing species, in urinary tract isolates from hospitalized patients in North America and Europe: results from the SMART study","volume":"74","author":"Hoban","year":"2012"},{"key":"R20","series-title":"Antimicrobial resistance surveillance in Europe 2010. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net)","author":"European Centre for Disease Prevention and Control (ECDC)","year":"2011"},{"key":"R21","series-title":"Infect Drug Resist","first-page":"215","article-title":"Resistance to antimicrobial drugs in Ghana","volume":"4","author":"Newman","year":"2011"},{"key":"R22","series-title":"Ghana J. of Allied Health Sciences","first-page":"15","article-title":"Neonatal infections: is extended-spectrum \u03b2-lactamase-producing gram-negative bacilli part of the problem?","volume":"3","author":"Codjoe","year":"2009"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/89\/5\/article-p960.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/89\/5\/article-p960.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/89\/5\/article-p960.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T14:17:14Z","timestamp":1723040234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/89\/5\/article-p960.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,6]]},"references-count":22,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.12-0642","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11,6]]}}}