Antibiotic resistance is increasing dramatically worldwide. In some countries so-called pan-resistant bacteria, i.e. resistant towards all available drugs, are causing serious infections in hospitals, but are also spread due to international travel and trade of foods (Falagas et al. 2006).
Development of antibiotic resistance is closely related to the consumption of antibiotics. There is a clear trend between high levels of resistance and high levels of antibiotic consumption, e.g. in southern European countries and vice versa in the Nordic countries.
This correlation holds both for humans and production animals, i.e. high resistance levels in zoonotic bacteria like Salmonella spp. stem from antibiotic use in production animals.
In developing countries, e.g. Ghana, increasing prevalences of resistance towards various antibiotic groups have been reported in several important bacterial pathogens (Newman and Seidu 2002; Newman et al. 2007; Newman et al. 2006; Denno et al. 2002; Mills-Robertson et al. 2002).
In a recent study in Accra, 30% of S. aureus was found resistant to methicillin (MRSA) (Newman, personal communication). A Ghanaian-Dutch collaborative effort to evaluate antibiotic resistance in Ghana found extremely high prevalences of resistance in Gram-negative bacteria isolated from hospitalized patients: E. coli: tetracycline, 82%; ampicillin, 75%; chloramphenicol, 75% ; co-trimoxazole, 72%.; nalidixic acid, 49%; and cefotaxime, 20%. Similar resistance prevalences were recorded in other gastro-intestinal pathogens including Salmonella spp. which may also cause bacteraemia (Newman et al. 2006). Furthermore, E. coli isolated from stools of healthy volunteers in Ghana showed > 80% resistance towards ampicillin, tetracycline, chloramphenicol and co-trimoxazole (Nys et al. 2004).
This limited information indicates a widespread prevalence of antibiotic resistance in the clinically most important bacterial pathogens in Ghana (Nys et al. 2004), and shows that resistance is likely a serious problem both for community-acquired as well as for nosocomial infections.
from ADMER project