Abstract
Wound infections are common medical problems in sub-Saharan Africa but data on the molecular epidemiology are rare. Within this study we assessed the clonal lineages, resistance genes and virulence factors of Gram-negative bacteria isolated from Ghanaian patients with chronic wounds. From a previous study, 49 Pseudomonas aeruginosa, 21 Klebsiella pneumoniae complex members and 12 Escherichia coli were subjected to whole genome sequencing. Sequence analysis indicated high clonal diversity with only nine P. aeruginosa clusters comprising two strains each and one E. coli cluster comprising three strains with high phylogenetic relationship suggesting nosocomial transmission. Acquired beta-lactamase genes were observed in some isolates next to a broad spectrum of additional genetic resistance determinants. Phenotypical expression of extended-spectrum beta-lactamase activity in the Enterobacterales was associated with blaCTX-M-15 genes, which are frequent in Ghana. Frequently recorded virulence genes comprised genes related to invasion and iron-uptake in E. coli, genes related to adherence, iron-uptake, secretion systems and antiphagocytosis in P. aeruginosa and genes related to adherence, biofilm formation, immune evasion, iron-uptake and secretion systems in K. pneumonia complex. In summary, the study provides a piece in the puzzle of the molecular epidemiology of Gram-negative bacteria in chronic wounds in rural Ghana.
Highlights
The microbiology of chronic infected wounds, on a molecular level, is poorly understood in sub-Saharan Africa (SSA) [1]
Clustering Based on Core Genome Multilocus Sequence Typing Results
No clusters were identified among the 21 assessed K. pneumonia complex members, which were all singletons with differences ranging from 647 to 2244 alleles
Summary
The microbiology of chronic infected wounds, on a molecular level, is poorly understood in sub-Saharan Africa (SSA) [1]. From other parts in the world, in particular from industrialized countries, information on the microbiology and the role of biofilm-forming microorganisms causing such infections are well established [7,8,9,10]. Pseudomonas aeruginosa is amongst the most frequently isolated Gram-negative bacteria, associated with biofilm formation [11,12]. It was shown that skin colonization with Gram-negative bacteria is frequent in resource-limited (sub)tropical settings [19,20,21], in contrast to skin colonization of individuals from industrialized countries, where Grampositive bacteria dominate [19]. Temperature and moisture have been discussed as likely reasons for the difference seen [22]
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