Asiedu Samuel O, Kini Priscilla, Aglomasa Bill C, Amewu Emmanuel K A, Asiedu Ebenezer, Wireko Solomon, Boahen Kennedy G, Berbudi Afiat, Sylverken Augustina A, Kwarteng Alexander
Department of Theoretical and Applied Biology Kwame Nkrumah University of Science and Technology Kumasi Ghana.
Kumasi Centre for Collaborative Research in Tropical Medicine Kwame Nkrumah University of Science and Technology Kumasi Ghana.
Health Sci Rep. 2022 Jul 20;5(4):e724. doi: 10.1002/hsr2.724. eCollection 2022 Jul.
Lymphatic Filariasis (LF), a neglected tropical disease, has been speculated to be complicated by secondary bacteria, yet a systematic documentation of these bacterial populations is lacking. Thus, the primary focus of this study was to profile bacteria diversity in the progression of filarial lymphedema among LF individuals with or without wounds.
A cross-sectional study design recruited 132 LF individuals presenting with lymphedema with or without wounds from eight communities in the Ahanta West District in the Western Region, Ghana. Swabs from the lymphedematous limbs, ulcers, pus, and cutaneous surfaces were cultured using standard culture-based techniques. The culture isolates were subsequently profiled using Matrix-assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry.
Of the 132 LF participants recruited, 65% (85) had filarial lymphedema with no wounds. In total, 84% (235) of the bacterial isolates were identified. The remaining 16% (46) could not be identified with the method employed. Additionally, 129(55%) of the strains belonged to the phylum Firmicutes, while 61 (26%) and 45 (19%) represented Proteobacteria and Actinobacteria, respectively. Generally, irrespective of the samples type (i.e., wound sample and non-wound samples), there was a sharp increase of bacteria diversity from Stages 1 to 3 and a drastic decrease in these numbers by Stage 4, followed by another surge and a gradual decline in the advanced stages of the disease. The Shannon Diversity Index and Equitability for participants with and without wounds were (3.482, 0.94) and (3.023, 0.75), respectively. Further, and showed resistance to tetracycline, chloramphenicol, and penicillin.
The present study reveals a sharp decline in bacterial load at the late stages of filarial lymphedema patients. In addition, we report an emerging antimicrobial resistance trend of and against commonly used antibiotics such as tetracycline, chloramphenicol, and penicillin in communities endemic for LF in the Ahanta West District, Ghana. This could pose a huge challenge to the management of the disease; particularly as current treatments are not quite effective against the infection.
淋巴丝虫病（LF）是一种被忽视的热带病，据推测可能会并发继发性细菌感染，但目前缺乏对这些细菌种群的系统记录。因此，本研究的主要重点是分析有无伤口的淋巴丝虫病患者丝虫性淋巴水肿进展过程中的细菌多样性。
采用横断面研究设计，从加纳西部地区阿汉塔西区的8个社区招募了132名患有或未患有伤口的淋巴丝虫病性淋巴水肿患者。使用基于标准培养的技术对来自淋巴水肿肢体、溃疡、脓液和皮肤表面的拭子进行培养。随后使用基质辅助激光解吸/电离飞行时间质谱对培养分离株进行分析。
在招募的132名淋巴丝虫病参与者中，65%（85名）患有无伤口的丝虫性淋巴水肿。总共鉴定出84%（235株）的细菌分离株。其余16%（46株）无法用所采用的方法鉴定。此外，129株（55%）菌株属于厚壁菌门，而61株（26%）和45株（19%）分别代表变形菌门和放线菌门。一般来说，无论样本类型（即伤口样本和非伤口样本）如何，从第1阶段到第3阶段细菌多样性急剧增加，到第4阶段这些数量急剧下降，随后在疾病晚期又出现一次激增并逐渐下降。有伤口和无伤口参与者的香农多样性指数和均匀度分别为（3.482，0.94）和（3.023，0.75）。此外，[具体细菌名称1]和[具体细菌名称2]对四环素、氯霉素和青霉素表现出耐药性。
本研究揭示了丝虫性淋巴水肿患者晚期细菌载量急剧下降。此外，我们报告了在加纳阿汉塔西区淋巴丝虫病流行社区中，[具体细菌名称1]和[具体细菌名称2]对四环素、氯霉素和青霉素等常用抗生素出现了新的耐药趋势。这可能给该疾病的管理带来巨大挑战；特别是因为目前的治疗方法对该感染不太有效。
