Spectrum Of Antibiotic Resistant Bacteria And Fungi Isolated From Chronically Infected Wounds In A Rural District Hospital In Ghana

Background Chronic infected wounds are generally difficult to manage and treatment can be particularly challenging in resource-limited settings where diagnostic testing is not readily available. In this study, the epidemiology of microbial pathogens in chronically infected wounds in rural Ghana was assessed to support therapeutic choices for physicians. Methods Culture-based bacterial diagnostics including antimicrobial resistance testing were performed on samples collected from patients with chronic wounds at a hospital in Asante Akim North Municipality, Ghana. Fungal detection was performed by broad-range fungal PCR and sequencing of amplicons. Results In total, 105 patients were enrolled in the study, from which 207 potential bacterial pathogens were isolated.Enterobacteriaceae(n = 84, 41%) constituted the most frequently isolated group of pathogens. On species level,Pseudomonas aeruginosa(n = 50, 24%) andStaphylococcus aureus(n = 28, 14%) were predominant. High resistance rates were documented, comprising 29% methicillin resistance inS.aureusas well as resistance to 3(rd)generation cephalosporins and fluoroquinolones in 33% and 58% ofEnterobacteriaceae, respectively. OneP.aeruginosastrain with carbapenem resistance was identified. The most frequently detected fungi wereCandida tropicalis. Conclusions The pathogen distribution in chronic wounds in rural Ghana matched the internationally observed patterns with a predominance ofP.aeruginosaandS.aureus. Very high resistance rates discourage antibiotic therapy but suggest an urgent need for microbiological diagnostic approaches, including antimicrobial resistance testing to guide the management of patients with chronic wounds in Ghana.