In a groundbreaking genomic surveillance effort, scientists from the Wellcome Sanger Institute, Oslo University Hospitals, and the University for Development Studies in Ghana have discovered that heavily antibiotic-resistant Klebsiella bacteria in Ghana are primarily confined to hospital settings.
This finding offers valuable insights for the development of targeted control measures against treatment-resistant infections.
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The Hospital-Centric Distribution of Antibiotic Resistance
This study, published on October 16, 2023, in The Lancet Microbe, indicates that heavily antibiotic-resistant strains of Klebsiella bacteria, specifically Klebsiella pneumoniae, responsible for treatment-resistant infections, are primarily found within clinical settings. The prevalence of these strains within hospitals in Ghana is similar to that in Italy. Notably, these heavily antibiotic-resistant strains are not prevalent in the environment or among animals. The study suggests that clinical antibiotic usage is a driving factor behind the development of antibiotic resistance in Klebsiella pneumoniae.
Understanding Klebsiella Pneumoniae
Klebsiella pneumoniae, a major human pathogen, has the capability to cause a wide range of infections, including pneumonia, meningitis, wound and soft tissue infections, urinary tract infections, and neonatal sepsis. The rise of antibiotic resistance, including multidrug resistance and the production of extended-spectrum beta-lactamases (ESBLs), poses a significant challenge. Some strains have even become resistant to carbapenems, broad-spectrum antibiotics used for stubborn infections.
Genomic Surveillance to Inform Control Measures
While genomic surveillance of Klebsiella has been conducted in multiple European countries, this study addresses the data gap in Ghana. Researchers sequenced 573 Klebsiella samples collected from clinical, environmental, and animal sources in the vicinity of Tamale, Ghana. The data was compared with previous studies conducted in Italy and Norway.
Among the samples, Klebsiella pneumoniae constituted a significant portion, with two antibiotic-resistant strains. Importantly, these resistant strains were predominantly found in clinical settings, highlighting the limited success of these strains outside the hospital environment.
The findings indicate that the clinical use of antibiotics, such as carbapenems, plays a pivotal role in driving antibiotic resistance. Without the selective pressure posed by clinical antibiotic usage, these antibiotic-resistant strains struggle to outcompete less dangerous bacterial forms.
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Aiding Public Health Measures
This study provides a foundation for public health efforts to reduce the spread of heavily antibiotic-resistant bacteria in hospital settings. By gaining insights into the localised distribution of these pathogens, public health authorities can develop more targeted strategies for control and surveillance. Genomic surveillance proves to be an invaluable tool for understanding the spread of antibiotic resistance and identifying key factors influencing its development.
Dr. Jessica Calland, the first author from Oslo University Hospitals, emphasises the importance of identifying strains that can cause treatment-resistant and potentially life-threatening infections. The study’s findings highlight the need for robust genomic surveillance, especially in countries heavily impacted by treatment-resistant pathogens.
The One Health approach employed in the study, which considers all environments where bacteria may persist, including hospitals, humans, and animals, offers a comprehensive view of potential pathways. This approach helps identify areas for focused interventions to combat antibiotic-resistant bacteria effectively.
Professor Jukka Corander from the Wellcome Sanger Institute underscores the global nature of antibiotic resistance as a public health problem. Genomic information on antibiotic resistance’s spread is crucial for slowing and ultimately halting its progression. Collaboration across borders is paramount in the fight against antibiotic-resistant bacteria, with efforts to mitigate their global impact on public health.
This study sheds light on the localised distribution of heavily antibiotic-resistant Klebsiella bacteria in Ghana, providing a foundation for targeted control measures and underlining the significance of genomic surveillance in addressing antibiotic resistance.