Extended Spectrum Beta-Lactamase Escherichia coli in River Waters Collected from Two Cities in Ghana, 2018-2020.

R A Banu ,Appiah-Korang Labi,Heike Schmitt,Selorm Borbor,David Opare,Anthony Reid,Gerard Quarcoo,Boi Kikimoto,Hayk Davtyan,Hawa Ahmed,Wendemagegn Enbiale,E.d.o Ansa ,Lady Asantewah Boamah Adomako ,M O Akrong ,Edith Andrews Annan ,Mohammed Bello Mustapha ,Jorge Matheu Alvarez ,George Kwesi Hedidor ,P Owiti ,Mike Y Osei-Atweneboana

doi:10.3390/tropicalmed6020105

Abstract

Infections by Extended-Spectrum Beta-Lactamase producing Escherichia coli (ESBL-Ec) are on the increase in Ghana, but the level of environmental contamination with this organism, which may contribute to growing Antimicrobial Resistance (AMR), is unknown. Using the WHO OneHealth Tricycle Protocol, we investigated the contamination of E. coli (Ec) and ESBL-Ec in two rivers in Ghana (Odaw in Accra and Okurudu in Kasoa) that receive effluents from human and animal wastewater hotspots over a 12-month period. Concentrations of Ec, ESBL-Ec and percent ESBL-Ec/Ec were determined per 100 mL sample. Of 96 samples, 94 (98%) were positive for ESBL-Ec. concentrations per 100 mL (MCs100) of ESBL-Ec and %ESBL-Ec from both rivers were 4.2 × 104 (IQR, 3.1 × 103–2.3 × 105) and 2.79 (IQR, 0.96–6.03), respectively. MCs100 were significantly lower in upstream waters: 1.8 × 104 (IQR, 9.0 × 103–3.9 × 104) as compared to downstream waters: 1.9 × 106 (IQR, 3.7 × 105–5.4 × 106). Both human and animal wastewater effluents contributed to the increased contamination downstream. This study revealed high levels of ESBL-Ec in rivers flowing through two cities in Ghana. There is a need to manage the sources of contamination as they may contribute to the acquisition and spread of ESBL-Ec in humans and animals, thereby contributing to AMR.

Highlights

The rising problem of Antimicrobial Resistance (AMR) is well recognised as a major public health threat [1,2]
There were no significant differences in Extended-Spectrum Beta-Lactamase producing Escherichia coli (ESBL-E. coli (Ec)) concentrations between animal wastewater samples from both cities. (Figure 2)
In rivers flowing through two cities in Ghana, we showed high concentrations of coli and relatively low but significant concentrations of ESBL-Ec cfu/100 mL from all water

Summary

Introduction

The rising problem of Antimicrobial Resistance (AMR) is well recognised as a major public health threat [1,2]. The increase in AMR is widely attributed to inappropriate use of antimicrobials in humans and animal husbandry [5,6] with a resulting impact on the environment, which may, in turn, be a source for the acquisition and transfer of resistant genes. Available studies on AMR and the environment are predominantly from high resource settings [7,8,9], with a gap in knowledge from low and middle-income settings [10,11]. AMR is facilitated by the discharge of poorly treated human and animal waste as well as antimicrobials from pharmaceutical industries and health facilities into the environment [12,13].

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Results

Discussion

Conclusion