Tetracycline Resistance Pattern Among Lymphatic Filariasis-Hyperendemic Communities in Southern Ghana: A Mixed-Method...

Area of Science:

• Tropical medicine
• Infectious diseases
• Antimicrobial resistance

Background:

• Tetracyclines are vital for treating infections in resource-limited areas, including lymphatic filariasis (LF).
• Increased tetracycline use for LF-related conditions necessitates monitoring resistance patterns.
• This study addresses antibiotic knowledge, attitudes, practices, and resistance in LF-endemic communities.

Purpose of the Study:

• To evaluate antibiotic knowledge, attitude, and practice (KAP) among patients in LF-endemic communities.
• To determine the resistance profiles of tetracycline-class antibiotics against wound bacteria.
• To assess the clinical impact of resistance on anti-Wolbachia therapies for LF.

Main Methods:

• Cross-sectional study in Ghana involving 71 filarial lymphedema patients.
• Structured questionnaires assessed KAP regarding antibiotic use and resistance.
• Microbiological analysis of wound swabs from 28 patients to profile the microbiome and test tetracycline resistance.

Main Results:

• Low mean scores for antibiotic knowledge (1.8), attitude (1.4), and practice (1.9), with a combined KAP score of 5.0 (31.2%).
• Primary healthcare facilities stocked tetracycline and/or doxycycline.
• Identified 68 bacterial isolates with varied resistance: doxycycline (35.3%), tetracycline (26.5%), minocycline (17.6%).
• The tet(M) gene was detected in 34.1% of isolates, indicating resistance mechanisms.

Conclusions:

• Multifaceted strategies are essential to combat tetracycline resistance and overuse.
• Culturally adapted education is needed to improve antibiotic stewardship.
• Optimized wound care and ongoing resistance surveillance are recommended.