Public Toilets in a tertiary institution in the Southern part of Nigeria as Potential Reservoirs of Drug Resistant Pathogens

K Otokunefor,J.A Kalio,D.C Chijioke,G.O Abu

doi:10.4314/njb.v37i1.8

Abstract

Toilets have long been viewed as a significant potential contributor to human infectious diseases. Various studies worldwide have explored the bacterial communities associated with toilets but only few have focused on their possible role as reservoirs of drug resistant pathogens. To explore this role, four different surfaces from a pay-to-use toilet complex at a tertiary institution in the Southern part of Nigeria were sampled using the swab-rinse technique. Sample processing was done to determine bacterial load, identify bacterial types present in the samples and determine antibiotic susceptibility using standard techniques. Similar levels of bacterial contamination were observed at all the 14 sampling points ranging from 3.6×104 to 2.7×105 CFU. A higher level of contamination was generally noted on the door handles and floor surfaces. Of the ten different bacterial groups identified, Shigella sp. and Salmonella sp. were the predominant groups (20.6% each). The test isolates showed a wide rate of resistance to antibiotics, with the highest observed against ofloxacin (98.3%) and the least against ceftriaxone (44.4%). Forty-three different antibiogram patterns were detected among the test isolates. Most of the bacteria (63.2%) were associated with MAR index values greater than 0.8. This study shows that public toilets could play a role not just as a reservoir of potential pathogens but more specifically as a potential reservoir of drug resistant pathogenic microorganisms with high MAR indices. Keywords: Toilet, Reservoir, MAR index, Nigeria

Highlights

Toilets have long been viewed as a significant potential contributor to human infectious diseases, with the transmission of many diarrhoeal diseases thought to be associated with toilets (Mkrtchyan et al, 2013; Kaewla and Wiwanikit, 2014; Johnson et al, 2017)
Various studies worldwide have explored the bacterial communities associated with toilets but only few have focused on their possible role as reservoirs of drug resistant pathogens
This study shows that public toilets could play a role not just as a reservoir of potential pathogens but as a potential reservoir of drug resistant pathogenic microorganisms with high MAR indices

Summary

Introduction

Toilets have long been viewed as a significant potential contributor to human infectious diseases, with the transmission of many diarrhoeal diseases thought to be associated with toilets (Mkrtchyan et al, 2013; Kaewla and Wiwanikit, 2014; Johnson et al, 2017). A large number of people worldwide rely on shared or public toilet facilities These play a potentially crucial role in public health due to the higher number of users than private facilities, as well as often reduced levels of hygiene (Gerhardts et al, 2012; McGinnis et al, 2019). Various studies worldwide have explored the bacterial communities associated with toilets. These studies found a wide variety of bacterial types associated with different toilet surfaces, mostly potentially pathogenic species (Mkrtchyan et al, 2013; Adewoyin et al, 2013; Chengula et al, 2014). A recent study (McGinnis et al, 2019) noted a significant difference in the levels of bacterial load between community and household toilet facilities with higher levels observed in the community facilities.

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