Tracking of multidrug-resistant pathogen clones in Ghana: a systematic review and meta-analysis

Introduction: Antimicrobial resistance (AMR) threatens effective antibiotic treatment. Multidrug-resistant (MDR) bacterial clones pose a particular challenge because they facilitate rapid resistance dissemination. Tracking dominant antibiotic-resistant clones in Ghana will inform targeted surveillance and control. This systematic review characterised prevalent MDR clones of priority pathogens isolated from humans, animals, and the environment in Ghana. Methods: A search of PubMed, Scopus, and Web of Science databases was conducted from inception to October 4, 2024, for studies reporting genetic characterisation of MDR clones from Ghana. The risk of bias in the included studies was evaluated using the Newcastle–Ottawa scale (NOS), and data analysis involved descriptive statistics and proportional meta-analysis. Results: Twenty-five studies met the eligibility criteria, and 10 different MDR bacterial species were identified from human, animal, and environmental sources. The pooled prevalence of MDR bacteria was 53.4% (95% CI: 39.8–66.9). The dominant E. coli clones were ST155 (38.0%), ST617 (29.1%), and ST10 (11.1%). For K. pneumoniae, ST152 and ST17 were the main clones detected, each with a prevalence of 13.7%. ST39 was also present at 9.0%. The major S. pneumoniae clones were ST802 (18.5%), ST15111 (12.3%), and ST15448 (4.8%). ST152 (27.3%), ST121 (21.3%), and ST9 (14.3%) were predominant among the S. aureus isolates. The most prevalent Acinetobacter baumannii clone was ST231 (77.3%), followed by ST2145 (13.6%). Conclusion: This systematic review provided the first comprehensive overview of MDR clones that may be circulating in Ghana. The identification of high-risk clones, such as E. coli ST155 and S. aureus ST152, highlights the need for urgent public health interventions. Continued tracking using standardised WGS methodologies across diverse sources is crucial for guiding antimicrobial resistance containment in Ghana.