Comparison of nasopharyngeal bacteriological profile between patients with diabetes and healthy individuals in Accra, Ghana.

BACKGROUND

The nasopharynx is characterised by a rich microbial diversity, making it an important endogenous reservoir for respiratory infections. People living with diabetes (PLWD) have a high risk for acquisition of respiratory tract infections, but their nasopharyngeal bacterial flora have rarely been investigated.

AIM: To investigate the nasopharyngeal bacterial flora among PLWD and non-diabetics at the Korle Bu Teaching Hospital in Accra.

METHODOLOGY: This study was a case-control one, involving 130 each of PLWD and non-diabetics. Nasopharyngeal swab specimens were obtained from the participants and cultured for bacteria, which were identified using MALDITOF mass spectrometry.

RESULTS

The bacterial flora present in the anterior nares of the participants of both study groups was characterised by a rich diversity, comprising both Gram-positives and Gram-negatives. In the diabetics, the dominant bacteria were Acinetobacter baumannii (19.6%), Staphylococcus epidermidis (18.12%), Staphylococcus aureus (15.2%), and Rahnella aquatilis (12.3%). In the control group, however, the dominant bacteria were Staphylococcus epidermidis (21.9%), Staphylococcus aureus (19.0%), Proteus mirabilis (10.9%), Pseudomonas aeruginosa (10.2%), Acinetobacter baumannii (8.8%), and Enterobacter cloacae (7.2%). Between groups, Acinetobacter baumannii (19.6% vs. 8.8%, p = 0.014) and Rahnella aquatilis (12.3% vs. 0.0%, p < 0.001) recorded a significantly higher prevalence in the diabetes group than in the control group. On the contrary, Klebsiella pneumoniae (0.0% vs. 4.4%, p = 0.003), Proteus mirabilis (2.2% vs. 10.9%, p = 0.006), and Pseudomonas aeruginosa (0.7% vs. 10.2%, p < 0.001) had significantly lower prevalence than in the control group.

CONCLUSION

The nasopharyngeal bacterial flora of PLWD in Accra seems to have comparable diversities with those of non-diabetics. Nonetheless, the PLWD had a higher carriage rate of Acinetobacter baumannii but seem to have some protection against carriage of Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa.