Abstract
Salmonellosis is an important but neglected disease in sub-Saharan Africa. Food or fecal-oral associated transmissions are the primary cause of infections, while the role of waterborne transmission is unclear. Samples were collected from different dug wells in a rural area of Ghana and analyzed for contamination with bacteria, and with Salmonella in particular. In addition, temporal dynamics and riks factors for contamination were investigated in 16 wells. For all Salmonella isolates antibiotic susceptibility testing was performed, serovars were determined and strains from the same well with the same serovar were genotyped. The frequency of well water contamination with Gram-negative rod-shaped bacteria was 99.2% (n = 395). Out of 398 samples, 26 (6.5%) tested positive for Salmonella spp. The serovar distribution was diverse including strains not commonly isolated from clinical samples. Resistance to locally applied antibiotics or resistance to fluoroquinolones was not seen in the Salmonella isolates. The risk of Salmonella contamination was lower in wells surrounded by a frame and higher during the rainy season. The study confirms the overall poor microbiological quality of well water in a resource-poor area of Ghana. Well contamination with Salmonella poses a potential threat of infection, thus highlighting the important role of drinking water safety in infectious disease control.
Highlights
Non-typhoid Salmonella (NTS) are distributed worldwide, in industrialized, as well as in resource-limited countries
The analysis is divided into the following parts: (i) well contamination with Gram-negative rod-shaped bacteria and Salmonella, (ii) Salmonella serovars and antibiotic susceptibility, (iii) Pulsed-field gel electrophoresis (PFGE)
The main findings of this study are that (i) the majority of well water samples (99.2%) were contaminated with Gram-negative rod-shaped bacteria with >100 colony forming units (CFU)/100 mL, (ii) 6.5% of water samples were contaminated with Salmonella, (iii) resistance to locally administered antibiotics was negligible in the Salmonella strains isolated from well water, (iv) the serovar distribution consisted of serovars not typically seen in clinical specimens, (v) wells were colonized by strains that persist for several weeks and (vi) certain well characteristics were associated with Salmonella contamination
Summary
Non-typhoid Salmonella (NTS) are distributed worldwide, in industrialized, as well as in resource-limited countries. Humans get infected with Salmonella through the consumption of contaminated food of animal origin, such as poultry, egg and milk products, and contaminated water, or via the fecal-oral route. In Africa, access to bottled drinking water especially in rural areas is rare and the role of drinking water in Salmonella infection is unclear. Previous studies in Africa have emphasized the problem of drinking water contamination with fecal bacteria and with Salmonella, indicating that such water may be unsafe for consumption [7,8]. In Ghana, little information is available on the prevalence of Salmonella serovars in water sources and whether these are associated with human infections.
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