TITLE:
Characterization of Respiratory Bacterial Co-Infection among Patients with COVID-19 in Ghana
AUTHORS:
Adwoa Asante-Poku, Esther Nimsaah Addae, Stephen Osei-Wusu, Abdul Halim Osman, Christian Bonsu, Mohammed Yussif, Samual Darkwah, Eric Sampane-Donkor
KEYWORDS:
COVID-19, Antimicrobial Resistance, Respiratory Infections, Bacterial Co-Infection, Nasopharyngeal Carriage, Oropharyngeal Microbiota, Ghana, Comorbidities
JOURNAL NAME:
Advances in Microbiology,
Vol.15 No.8,
August
28,
2025
ABSTRACT: The COVID-19 pandemic significantly challenged Ghana’s healthcare system, exacerbated by a rise in bacterial co-infections in patients. The rising prevalence of antibiotic consumption in this setting is driving antimicrobial resistance, as documented in recent studies from Ghana. Individuals infected with the virus have a higher prevalence of bacterial simultaneous and sequential co-infections and present a greater prevalence of drug-resistant bacteria compared to non-infected individuals. This study aimed to investigate the prevalence of respiratory bacterial co-infections among COVID-19 patients and assess their antibiotic resistance profiles to improve bacterial infection care. A cross-sectional analysis was conducted involving 216 COVID-19 patients and 92 RT-PCR negative controls from major testing centres in Greater Accra. Utilizing microbial culture techniques to examine nasopharyngeal and oropharyngeal samples alongside statistical analysis of clinical and demographic data, findings were categorized based on COVID-19 test results, demographics, clinical characteristics, and duration of hospital stay. The results indicated higher COVID-19 positivity rates among males, younger age groups (19 - 38 years), and inpatients, with these patients also exhibiting a significant proportion of bacterial carriage. Although co-infection rates were similar in patients with reported infections like HIV, malaria, diabetes, and hypertension, COVID-19 patients had much higher levels of antibiotic-resistant bacteria. This underscores the urgent need for enhanced antibiotic stewardship to tackle rising antimicrobial resistance, particularly among vulnerable populations. Overall, the study strengthens understanding of the link between respiratory infections and antibiotic resistance, advocating for integrated One Health approaches to improve public health outcomes.