Carbapenem resistance is a major and an on-going public health problem globally. It occurs mainly among Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, and may be intrinsic or mediated by transferable carbapenemase-encoding genes. This type of resistance genes are already widespread in certain parts of the world, particularly Europe, Asia and South America, while the situation in other places such as sub-Saharan Africa is not well documented. In this paper, we provide an in-depth review of carbapenem resistance providing up-to-date information on the subject.

Fungal infections are increasingly becoming common and yet often neglected in developing countries. Information on the burden of these infections is important for improved patient outcomes. The burden of serious fungal infections in Ghana is unknown. We aimed to estimate this burden. Using local, regional, or global data and estimates of population and at-risk groups, deterministic modelling was employed to estimate national incidence or prevalence. Our study revealed that about 4% of Ghanaians suffer from serious fungal infections yearly, with over 35,000 affected by life-threatening invasive fungal infections. Incidence of cryptococcal meningitis, Pneumocystis jirovecii pneumonia, and disseminated histoplasmosis cases in AIDS was estimated at 6275, 12,610 and 724, respectively. Oral and esophageal candidiasis collectively affect 27,100 Ghanaians and 42,653 adult asthmatics are estimated to have fungal asthma. We estimate a prevalence of 12,620 cases of chronic pulmonary aspergillosis (CPA and an incidence of 1254 cases of invasive aspergillosis (IA). Estimated cases of candidemia and candida peritonitis cases were 1446 and 217, respectively. The estimated prevalence of recurrent vulvovaginal candidiasis (RVVC) and tinea capitis was 442,621 and 598,840, respectively. Mucormycosis and fungal keratitis each may affect 58 and 810 Ghanaians. These data highlight the urgent need for intensified awareness to improve diagnosis and management.

Objectives: This study aimed to determine the aetiology of Urinary tract infections (UTI), resistant profiles of isolated bacteria, and virulence factors of Escherichia coli associated with bacteriuria in diabetic patients in Ghana. Methods: Mid-stream urine samples were tested for uropathogens from 982 diabetic patients at the National Diabetes and Research Centre in Ghana using standard bacteriological method and antibiogram was tested on the isolates using the Kirby-Bauer disc diffusion as per CLSI guidelines. Polymerase chain reaction (PCR) was used to investigate the phylogenetic groupings and virulence factor genes (VF) of isolated E. coli. conclusions, Results: The overall prevalence of UTI in was 9.2%, and the main uropathogens were Klebsiella spp. (55.6%), and Escherichia coli (31.3%). Age, duration of diabetes and previous history of UTI were risk factors associated with UTI (p-value < 0.05). High levels of antibacterial resistance were observed to cefuroxime (84%) and ampicillin (80%), and gentamicin (70.7%). The distribution of VF in each phylogenetic group revealed sfa-iutA-KpsTMII-KpsTMIII genes were associated with group B2, and iutA-ibe were associated with group D. Conclusions: The isolated uropathogens were highly resistant and the E. coli isolates were had varying VFs. Continuous monitoring of bacteria associated with UTI in diabetics is highly recommended.