Prevalence and antibiotic susceptibility patterns of enteric bacterial pathogens in human and non-human sources in an urban informal settlement in Cape Town, South Africa

John Bosco Kalule,John Bosco Kalule,Karen H Keddy,Nomsa P Tau,Lourens Robberts,Lourens Robberts,Mjikisile Vulindhlu,Mark P Nicol,Mark P Nicol,Anthony M Smith

doi:10.1186/s12866-019-1620-6

Abstract

BackgroundIn light of rampant childhood diarrhoea, this study investigated bacterial pathogens from human and non-human sources in an urban informal settlement.Meat from informal abattoirs (n = 85), river water (n = 64), and diarrheic stool (n = 66) were collected between September 2015 and May 2016. A duplex real-time PCR, gel-based PCR, and CHROMagar™STEC were used to screen Tryptic Soy Broth (TSB) for diarrheic E. coli. Standard methods were used to screen for other selected food and waterborne bacterial pathogens.ResultsPathogens isolated from stool, meat, and surface water included Salmonella enterica (6, 5, 0%), Plesiomonas shigelloides (9, 0, 17%), Aeromonas sobria (3, 3, 0%), Campylobacter jejuni (5, 5, 0%), Shigella flexneri (17, 5, 0%), Vibrio vulnificus (0, 0, 9%), and diarrheic E. coli (21, 3, 7%) respectively. All the isolates were resistant to trimethoprim–sulphamethoxazole.ConclusionsThere was a high burden of drug resistant diarrheal pathogens in the stool, surface water and meat from informal slaughter. Integrated control measures are needed to ensure food safety and to prevent the spread of drug resistant pathogens in similar settings.

Highlights

In light of rampant childhood diarrhoea, this study investigated bacterial pathogens from human and non-human sources in an urban informal settlement
Diarrheal disease is a major cause of morbidity in the Western Cape province and the city of Cape Town in South Africa [1]
Public primary health care practice in South Africa relies on the syndromic management of diarrheal disease [7]

Summary

Introduction

In light of rampant childhood diarrhoea, this study investigated bacterial pathogens from human and non-human sources in an urban informal settlement. Standard methods were used to screen for other selected food and waterborne bacterial pathogens. Diarrheal disease is a major cause of morbidity in the Western Cape province and the city of Cape Town in South Africa [1]. Infant mortality from diarrhea in South Africa is characterized by a seasonal unimodal peak from March – June each year [2]. The South African Standard Treatment Guidelines (STGs) for acute diarrhoea in children recommend rehydration and a single dose of intramuscular ceftriaxone at 80 mg/kg for infants (< 4 weeks old), the malnourished, and where danger signs exist. For dysentery, the STGs indicate treatment with oral ciprofloxacin (15 mg/kg 12 hourly for three days) followed by treatment for amoebic dysentery if symptoms do not improve after three days [8]

Methods

Results

Discussion

Conclusion