Explore the vast range of titles available.

Background Mycoplasma genitalium (MG), a sexually transmitted infection (STI), has emerged as a common cause of non-gonococcal urethritis and cervicitis worldwide, with documented resistance to commonly used antibiotics including doxycycline and azithromycin. Data in Ghana regarding the prevalence of MG is limited. Methods This retrospective study investigated MG presence and macrolide resistance among patients who previously reported to selected clinics for STI symptoms between December 2012 and June 2020. Samples were screened for MG and mutations associated with azithromycin resistance were investigated using Nucleic Acid Amplification Testing (NAAT) including the Resistance Plus MG ® kit from SpeeDx and the LightMix ® kit for MG, combined with the Modular Mycoplasma Macrolide from TIB Molbiol. Results A total of 1,015 samples were screened, out of which MG infection rate by TIB Molbiol and SpeeDx were 3.1% and 3.4%, respectively. The mutation responsible for macrolide resistance was detected in one MG positive sample by both assays. Both diagnostic tests revealed no significant association between MG infection and socio-demographic characteristics, clinical symptoms, gonorrhea, and chlamydia infection status. There was no significant difference in the mycoplasma percentage positivity rate detected using SpeeDx (3.4%) and TIB Molbiol (3.1%). Conclusions While not commonly tested as a cause of STI symptoms, MG is widespread in Ghana, exhibiting symptoms and prevalence comparable to those in other countries and linked to antimicrobial resistance. Future research using various molecular techniques is essential to monitor resistance trends and guide future antibiotic choices.

Yellow fever virus, transmitted by infected Aedes spp. mosquitoes, causes an acute viral hemorrhagic disease. During October 2021-February 2022, a yellow fever outbreak in some communities in Ghana resulted in 70 confirmed cases with 35 deaths (case-fatality rate 50%). The outbreak started in a predominantly unvaccinated nomadic community in the Savannah region, from which 65% of the cases came. The molecular amplification methods we used for diagnosis produced full-length DNA sequences from 3 confirmed cases. Phylogenetic analysis characterized the 3 sequences within West Africa genotype II; strains shared a close homology with sequences from Cote d'Ivoire and Senegal. We deployed more sensitive advanced molecular diagnostic techniques, which enabled earlier detection, helped control spread, and improved case management. We urge increased efforts from health authorities to vaccinate vulnerable groups in difficult-to-access areas and to educate the population about potential risks for yellow fever infections.

We conducted a retrospective cohort study that tested 2,000 US military personnel for Coccidioides antibodies in a disease-endemic region. The overall incidence of seroconversion was 0.5 cases/100 person-years; 12.5% of persons who seroconverted had illnesses requiring medical care. No significant association was found between demographic characteristics and seroconversion or disease.

Recent reports of haemagglutinin antigen (HA) mismatch between vaccine composition strains and circulating strains, have led to renewed interest in influenza B viruses. Additionally, there are concerns about resistance to neuraminidase inhibitors in new influenza B isolates. To assess the potential impact in Ghana, we characterized the lineages of influenza B viruses that circulated in Ghana between 2016 and 2017 from different regions of the country: Southern, Northern and Central Ghana. Eight representative specimens from the three regions that were positive for influenza B virus by real-time RT-PCR were sequenced and compared to reference genomes from each lineage. A total of eleven amino acids substitutions were detected in the B/Victoria lineage and six in the B/Yamagata lineage. The strains of influenza B viruses were closely related to influenza B/Brisbane/60/2008 and influenza B/Phuket/3073/2013 for the Victoria and Yamagata lineages, respectively. Three main amino acid substitutions (P31S, I117V and R151K) were found in B/Victoria lineages circulating between 2016 and 2017, while one strain of B/Victoria possessed a unique glycosylation site at amino acid position 51 in the HA2 subunit. Two main substitutions (L172Q and M251V) were detected in the HA gene of the B/Yamagata lineage. The U.S. CDC recently reported a deletion sub-group in influenza B virus, but this was not identified among the Ghanaian specimens. Close monitoring of the patterns of influenza B evolution is necessary for the efficient selection of representative viruses for the design and formulation of effective influenza vaccines.

Background: In Ghana, treatment of surgical site infections (SSIs) is often empirical and not based on targeted therapy (ie, knowledge of the organisms infecting surgical sites or their susceptibility profiles). This empirical approach most often leads to inappropriate prescription, which is a major driver of antimicrobial resistance. Using phenotypic and molecular tools, we investigated S. aureus , E. coli , K. pneumoniae , and P. aeruginosa recovered from patients with SSIs. Methods: Identification of bacteria species recovered from wound swabs and aspirates was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy (MALDI-TOF MS). Antimicrobial susceptibility testing (AST) was done using the Kirby-Bauer disk diffusion method. Results were interpreted according to the CLSI 2018 guidelines. Extended-spectrum β-lactamase (ESBL) positivity was detected among the gram-negative isolates using the double disk-diffusion method and PCR amplification of ESBL genes ( bla SHV, bla TEM, and bla CTX-M). Staphylococcus aureus isolates resistant to cefoxitin were further tested for the presence of mecA using PCR. Results: In total, 312 patients were enrolled in this prospective study. The 243 bacteria species identified comprised Escherichia coli (34%; 107 of 312), Klebsiella pneumoniae (20%; 62 of 312), Pseudomonas aeruginosa (16%; 49 of 312), and S. aureus (8%; 25 of 312). S. aureus isolates were susceptible to clindamycin, erythromycin, gentamicin, linezolid, rifampicin, and norfloxacin, but 10 S. aureus isolates were resistant to cefoxitin and were positive for the mecA gene (MRSA). Among the 169 isolates in the Enterobactericae category ( E. coli and K. pneumoniae ), 143 (85%) were resistant to tetracycline; 141 (83%) were resistant to trimethoprim–sulfamethoxazole; 118 (70%) were resistant to cefotaxime; 111 (66%) were resistant to cefuroxime; 98 (58%) were resistant to ciprofloxacin; 86 (51%) were resistant to gentamicin; and 81 (48%) were resistant to chloramphenicol. However, 161 (95%) were sensitive to amikacin and 159 (94%) were sensitive to meropenem. Among the 49 P. aeruginosa isolates, 45 (92%) showed sensitivity to amikacin, 43 (88%) showed sensitivity to meropenem, 35 (71%) showed sensitivity to gentamicin, and 35 (71%) showed sensitivity to ciprofloxacin. ESBL was detected in 59 (55%) of 107 E. coli isolates, and 48 (77%) of 62 K. pneumoniae isolates. bla CTX-M was the dominant ESBL gene in E. coli isolates (34 of 59, 58%). For K. pneumoniae isolates, bla CTX-M genes were detected in 45 (94%) of 48 isolates and bla SHV genes were detected in 44 (92%) of 48 isolates. Among the 49 P. aeruginosa isolates, 3 harbored the bla TEM gene. Conclusions: The findings of high proportions of ESBL-producing bacteria species in Ghana is a grave public health concern. Data generated in this study will inform treatment decisions and policies and appropriate antibiogram development and will support antimicrobial stewardship programs at the respective healthcare facilities in Ghana. Funding: None Disclosures: None

Background Unregulated and inappropriate antimicrobial use are major contributors to the evolution of antimicrobial resistance worldwide. It is important to monitor and collect data on the use of antibiotics at health facilities and in the general population in order to support antimicrobial stewardship programs. Methods As part of a gonorrhea surveillance study that was conducted from June 2012 to Jan 2018, we administered a questionnaire to elicit information on the types of antimicrobials used by individuals to treat symptoms of a gonorrhea infection prior to presenting at five health facilities in Southern Ghana. Results Almost one-third (383/1,349; 28%) of study participants admitted taking one or more antimicrobial types before hospital presentation, while 138/383 (36%) of those who took antimicrobials could not remember what they ingested. A greater percentage of individuals who reported prior antimicrobial use before presentation at a health facility tested positive for gonorrhea by NAAT (30%), in contrast to 24% for those without prior treatment (p = 0.004). Penicillin and its derivatives, as well as ciprofloxacin and doxycycline, were the most used, while a few individuals reported taking drugs such as kanamycin and rifampin. Males were more likely than females to take an antimicrobial prior to attending a health center. Conclusion In order to curb excessive and inappropriate antimicrobial use, antibiotics used by patients before presenting at hospitals ought to be investigated by healthcare providers. It is recommended that health professionals receive continuing education on the consequences of unregulated antimicrobial use.

Dengue fever is expanding as a global public health threat including countries within Africa. For the past few decades, Cameroon has experienced sporadic cases of arboviral infections including dengue fever. Here, we conducted genomic analyses to investigate the origin and phylogenetic profile of Cameroon DENV-1 outbreak strains and predict the impact of emerging therapeutics on these strains. Bayesian and maximum-likelihood phylogenetic inference approaches were employed in virus evolutionary analyses. An in silico analysis was performed to assess the divergence in immunotherapeutic and vaccine targets in the new genomes. Six complete DENV-1 genomes were generated from 50 samples that met a clinical definition for DENV infection. Phylogenetic analyses revealed that the strains from the current study belong to a sub-lineage of DENV-1 genotype V and form a monophyletic taxon with a 2012 strain from Gabon. The most recent common ancestor (TMRCA) of the Cameroon and Gabon strains was estimated to have existed around 2008. Comparing our sequences to the vaccine strains, 19 and 15 amino acid (aa) substitutions were observed in the immuno-protective prM-E protein segments of the Dengvaxia® and TetraVax-DV-TV003 vaccines, respectively. Epitope mapping revealed mismatches in aa residues at positions E155 and E161 located in the epitope of the human anti-DENV-1 monoclonal antibody HMAb 1F4. The new DENV strains constitute a conserved genomic pool of viruses endemic to the Central African region that needs prospective monitoring to track local viral evolution. Further work is needed to ascertain the performance of emerging therapeutics in DENV strains from the African region.

Marburg virus causes a hemorrhagic fever that is similar to Ebola virus disease. In June 2022, three cases were identified in Ghana.

We conducted a retrospective cohort study that tested 2,000 US military personnel for Coccidioides antibodies in a disease-endemic region. The overall incidence of seroconversion was 0.5 cases/100 person-years; 12.5% of persons who seroconverted had illnesses requiring medical care. No significant association was found between demographic characteristics and seroconversion or disease.We conducted a retrospective cohort study that tested 2,000 US military personnel for Coccidioides antibodies in a disease-endemic region. The overall incidence of seroconversion was 0.5 cases/100 person-years; 12.5% of persons who seroconverted had illnesses requiring medical care. No significant association was found between demographic characteristics and seroconversion or disease.