Comparative Microbiology and Antimicrobial Resistance of Bacterial Isolates from Wound Specimens at Tertiary-Care Centres in Ghana and Germany: A Retrospective Two-Centre Study.
5 affiliations
- 1Department of Orthopedics and Trauma Surgery, Ho Teaching Hospital, Ho P.O. Box MA 374, Ghana.
- 2Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany.
- 3Department of Orthopedics and Trauma Surgery, Tamale Teaching Hospital, Salaga/Yendi Road, Eastern Tamale, Tamale P.O. Box TL 16, Ghana.
- 4Department of Orthopedics and Trauma Surgery, Cape Coast Teaching Hospital, Interberton Road, Cape Coast P.O. Box CT 1363, Ghana.
- 5Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, 53127 Bonn, Germany.
Abstract
Background: Antimicrobial resistance complicates the management of skin and soft tissue infections (SSTIs), particularly in low- and middle-income countries where microbiological surveillance remains limited. We compared the microbiological spectrum and antimicrobial resistance patterns of wound-associated SSTIs between tertiary-care hospitals in Ghana and Germany. Methods: This retrospective bicentric cohort study analysed routine microbiological data from 309 patients in Ghana and 294 patients in Germany. 329 bacterial isolates from Ghana and 816 bacterial isolates from Germany were included. Pathogen distribution, antimicrobial susceptibility, and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), third-generation cephalosporin-resistant (3GC-R) Enterobacterales, and carbapenem-resistant Gram-negative bacteria were compared descriptively. Results: The microbiological spectrum differed markedly between the two cohorts. Gram-negative bacteria predominated in Ghana (83.9%), whereas Gram-positive organisms predominated in Germany (62.9%). Escherichia coli, Pseudomonas aeruginosa, and Klebsiella spp. were the leading pathogens in Ghana, while Staphylococcus aureus was the predominant pathogen in Germany. Compared with Germany, Ghanaian isolates exhibited substantially higher resistance to third-generation cephalosporins, fluoroquinolones and aminoglycosides. 3GC-R Enterobacterales were identified in 52.8% and 15.6% of evaluable isolates in Ghana and Germany, respectively. Carbapenem resistance among evaluable Gram-negative isolates was detected in 15.2% and 11.2%, respectively. MRSA prevalence (45.2% vs. 4.1%) was also considerably higher in Ghana than in Germany. Conclusions: Wound-associated SSTIs in Ghana and Germany differ substantially in pathogen distribution and antimicrobial resistance profiles. The predominance of Gram-negative pathogens and the high resistance burden observed in the Ghanaian cohort highlight the need for strengthened microbiological surveillance and antimicrobial stewardship. Institution-specific resistance data are essential to optimize empirical antimicrobial therapy across different healthcare settings.
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BibTeX
@article{agyekum2026comparative,
title = {{Comparative Microbiology and Antimicrobial Resistance of Bacterial Isolates from Wound Specimens at Tertiary-Care Centres in Ghana and Germany: A Retrospective Two-Centre Study.}},
author = {Edward Kwame Agyekum and Johanna Thiele and Mohammed Issah Suglo Bukari and Reginald Jeff Maddy and Jonas Roos and Ernst Molitor and Gunnar Thorben Rembert Hischebeth and Kristian Welle},
journal = {Antibiotics (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/antibiotics15100959},
url = {https://europepmc.org/article/MED/42938700},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Microbiology and Antimicrobial Resistance of Bacterial Isolates from Wound Specimens at Tertiary-Care Centres in Ghana and Germany: A Retrospective Two-Centre Study.
AU - Edward Kwame Agyekum
AU - Johanna Thiele
AU - Mohammed Issah Suglo Bukari
AU - Reginald Jeff Maddy
AU - Jonas Roos
AU - Ernst Molitor
AU - Gunnar Thorben Rembert Hischebeth
AU - Kristian Welle
PY - 2026
DA - 2026/09/28
JO - Antibiotics (Basel, Switzerland)
DO - 10.3390/antibiotics15100959
UR - https://europepmc.org/article/MED/42938700
AB - Background: Antimicrobial resistance complicates the management of skin and soft tissue infections (SSTIs), particularly in low- and middle-income countries where microbiological surveillance remains limited. We compared the microbiological spectrum and antimicrobial resistance patterns of wound-associated SSTIs between tertiary-care hospitals in Ghana and Germany. Methods: This retrospective bicentric cohort study analysed routine microbiological data from 309 patients in Ghana and 294 patients in Germany. 329 bacterial isolates from Ghana and 816 bacterial isolates from Germany were included. Pathogen distribution, antimicrobial susceptibility, and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), third-generation cephalosporin-resistant (3GC-R) Enterobacterales, and carbapenem-resistant Gram-negative bacteria were compared descriptively. Results: The microbiological spectrum differed markedly between the two cohorts. Gram-negative bacteria predominated in Ghana (83.9%), whereas Gram-positive organisms predominated in Germany (62.9%). Escherichia coli, Pseudomonas aeruginosa, and Klebsiella spp. were the leading pathogens in Ghana, while Staphylococcus aureus was the predominant pathogen in Germany. Compared with Germany, Ghanaian isolates exhibited substantially higher resistance to third-generation cephalosporins, fluoroquinolones and aminoglycosides. 3GC-R Enterobacterales were identified in 52.8% and 15.6% of evaluable isolates in Ghana and Germany, respectively. Carbapenem resistance among evaluable Gram-negative isolates was detected in 15.2% and 11.2%, respectively. MRSA prevalence (45.2% vs. 4.1%) was also considerably higher in Ghana than in Germany. Conclusions: Wound-associated SSTIs in Ghana and Germany differ substantially in pathogen distribution and antimicrobial resistance profiles. The predominance of Gram-negative pathogens and the high resistance burden observed in the Ghanaian cohort highlight the need for strengthened microbiological surveillance and antimicrobial stewardship. Institution-specific resistance data are essential to optimize empirical antimicrobial therapy across different healthcare settings.
SN - 2079-6382
ER -