Vergleichende Untersuchungen der Nasenflora von Probanden aus Ghana und Deutschland

Comparing characteristics of nasal flora of subjects from Ghana and Germany

by Hannah Seeba
Doctoral thesis
Date of Examination:2015-08-12
Date of issue:2015-08-12
Advisor:Prof. Dr. Uwe Groß
Referee:Prof. Dr. Rainer Laskawi
Referee:Prof. Dr. Margarete Schön
Persistent Address: http://dx.doi.org/10.53846/goediss-5186

 

 

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Abstract

English

Purpose: This study aims at comparing the composition and resistance patterns of nasal flora by analyzing swab samples of subjects living in rural Ghana and subjects living in Germany. Special attention is paid to the various reasons for the development of antibiotic resistances, MRSA prevalence, and the nasal cavity resembling a reservoir of potentially pathogenic bacteria. Methods: 200 nasal swabs of patients of a Ghanaian polyclinic and 101 nasal swabs of healthy German volunteers were examined for bacterial growth and antibiotic resistances. 17 of the swabs taken from German subjects were sterile and were therefore not included in the statistics. Results: 17.5% of the swabs from of Ghanaian subjects and 57.1% of the swabs of the German volunteers showed exclusively apathogenic bacterial growth. Potentially pathogenic bacteria grew in 82.5% of the samples of Ghanaian patients and in 36.6% of the German subjects’ samples. MRSA was found in 3.0% of all swabs from of Ghanaians (accounting for 17.7% of all Staphylococcus aureus strains in this group). None of the Germans’ swabs showed MRSA growth. In 37.0% of the samples of Ghanaians and in 6.0% of the samples of German volunteers enterobacteriaceae were detected. Significant differences in antibiotic resistance patterns were found for chloramphenicol, oxacillin, erythromycin, and lincosamides. These were particularly obvious in staphylococci which, due to higher prevalence, accounted for higher significance. 43.5% of Ghanaian patients and only 7.1% of German volunteers received antibiotic treatment in the four weeks prior to swabbing. Only 22 of the Ghanaian patients saw a doctor for symptoms of respiratory tract infections; of these, 16 patients (72.7%) were populated with pathogenic bacteria (i.e. less than the average of all Ghanaian patients). Conclusion: Taking into account the differences in medical treatment and living conditions, a possible connection can be established between the nasal bacterial population and the antibiotic resistances in these bacteria. Chloramphenicol (rarely used in Germany anymore) showed a major variation in the two groups. With bacterial resistances becoming a more threatening issue, it seems crucial to thoroughly evaluate when and how to treat patients with antibiotics. Therefore, it is necessary to improve education about understanding the interrelation of treatment and resistance in both patients and medical staff.
Keywords: nasal bacterial flora; antibiotic resistance; chloramphenicol; resistance development; antibiotic treatment; MRSA; Ghana
Schlagwörter: Nasenflora; Antibiotikaresistenzen; Chloramphenicol; Resistenzentwicklung; Ghana; Antibiotikatherapie; Atemwegserreger
 
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