Abstract
Introduction: Community-acquired infections due to extended-spectrum beta-lactamase (ESBL) producing Escherichia coli are rising worldwide, resulting in increased morbidity, mortality, and healthcare costs, especially where poor sanitation and inadequate hygienic practices are very common.Objective: This study was conducted to investigate the prevalence and characterization of multidrug-resistant (MDR) and ESBL-producing E. coli in drinking water samples collected from Rohingya camps, Bangladesh.Methods: A total of 384 E. coli isolates were analyzed in this study, of which 203 were from household or point-of-use (POU) water samples, and 181 were from source water samples. The isolates were tested for virulence genes, ESBL-producing genes, antimicrobial susceptibility by VITEK 2 assay, plasmid profiling, and conjugal transfer of AMR genes.Results: Of the 384 E. coli isolates tested, 17% (66/384) were found to be ESBL producers. The abundance of ESBL-producers in source water contaminated with E. coli was observed to be 14% (27/181), whereas, 19% (39/203) ESBL producers was found in household POU water samples contaminated with E. coli. We detected 71% (47/66) ESBL-E. coli to be MDR. Among these 47 MDR isolates, 20 were resistant to three classes, and 27 were resistant to four different classes of antibiotics. Sixty-four percent (42/66) of the ESBL producing E. coli carried 1 to 7 plasmids ranging from 1 to 103 MDa. Only large plasmids with antibiotic resistance properties were found transferrable via conjugation. Moreover, around 7% (29/384) of E. coli isolates harbored at least one of 10 virulence factors belonging to different E. coli pathotypes.Conclusions: The findings of this study suggest that the drinking water samples analyzed herein could serve as an important source for exposure and dissemination of MDR, ESBL-producing and pathogenic E. coli lineages, which therewith pose a health risk to the displaced Rohingya people residing in the densely populated camps of Bangladesh.
Highlights
Community-acquired infections due to extended-spectrum beta-lactamase (ESBL) producing Escherichia coli are rising worldwide, resulting in increased morbidity, mortality, and healthcare costs, especially where poor sanitation and inadequate hygienic practices are very common
To screen for ESBL-producing E. coli, 384 isolates were cultured on ESBL CHROMagar
The ESBL producing E. coli was investigated for carbapenem resistance on CHROMagar KPC media, and none of the isolates was able to grow on CHROMagar KPC media
Summary
Community-acquired infections due to extended-spectrum beta-lactamase (ESBL) producing Escherichia coli are rising worldwide, resulting in increased morbidity, mortality, and healthcare costs, especially where poor sanitation and inadequate hygienic practices are very common. Extended-spectrum beta-lactamase (ESBL)-producing E. coli have been recognized as a major multidrug-resistant bacteria implicated in serious hospital and community-acquired infections worldwide, especially in places where poor sanitation, and inadequate hygienic practices are very common [1,2,3,4]. ESBLs and New Delhi Metallo beta-lactamase 1 (NDM1) producing E. coli were detected in drinking water and retail meat, respectively [10, 11]. Detection of ESBL-producing E. coli in drinking water samples is important to recognize the risk of transmission of antimicrobial resistance (AMR) and gastrointestinal diseases. Transmission of ESBLencoding genes among bacteria is often plasmid-mediated [15], and aquatic environments provide ideal settings for horizontal transfer of AMR genes encoded on various forms of mobile genetic elements [16]
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