Extended Spectrum Beta-Lactamase Escherichia coli in River Waters Collected from Two Cities in Ghana, 2018-2020
Banu, Regina Ama; Alvarez, Jorge Matheu; Reid, Anthony J; Enbiale, Wendemagegn; Labi, Appiah-Korang; Ansa, Ebenezer D O; Annan, Edith Andrews; Akrong, Mark Osa; Borbor, Selorm; Adomako, Lady A B; Ahmed, Hawa; Mustapha, Mohammed Bello; Davtyan, Hayk; Owiti, Phillip; Hedidor, George Kwesi; Quarcoo, Gerard; Opare, David; Kikimoto, Boi; Osei-Atwenebanoa, Mike Y; Schmitt, Heike
(2021) Tropical Medicine and Infectious Disease, volume 6, issue 2, pp. 1 - 19
(Article)
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
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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.
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Keywords: Antimicrobial resistance, ESBL-E. coli, Environment, Ghana, Operational research, Rivers, Sort it, Tricycle protocol, General Immunology and Microbiology, Public Health, Environmental and Occupational Health, Infectious Diseases
ISSN: 2414-6366
Publisher: MDPI AG
Note: Funding Information: 1 CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana; markosaakrong@gmail.com (M.O.A.); borborviich.sb@gmail.com (S.B.); asantewa84@gmail.com (L.A.B.A.); hawaahmed360@yahoo.com (H.A.); yarbello@yahoo.com (M.B.M.); gquarcoo@csir-water.com (G.Q.); oseiatweneboana@yahoo.co.uk (M.Y.O.-A.) 2 Department of Surveillance Prevention and Control of AMR, AMR Division, World Health Organization, Route de Sauverny 22, 1290 Versoix, Switzerland; matheujo@who.int 3 Operational Research Unit (LuxOR), Medical Department, Médecins Sans Frontières Operational Centre Brussels, L-1617 Luxembourg, Luxembourg; tony.reid@brussels.msf.org 4 Dermatovenereology Department, BahirDar Department University, BahirDar P.O. Box 1996, Ethiopia; wendemagegnenbiale@gmail.com 5 Amsterdam UMC, Academic Medical Centre, Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&I), University of Amsterdam, 1012 WX Amsterdam, The Netherlands 6 WHO Country Office, Ghana, 7 Ameda Street, Roman Ridge, Accra P.O. Box MB 142, Ghana; labia@who.int (A.-K.L.); hedidorg@who.int (G.K.H.) 7 Council for Scientific and Industrial Research-Animal Research Institute, Adenta-Frafraha, Achimota-Accra P.O. Box AH 20, Ghana; edoansa@yahoo.com 8 World Health Organization, Harare, Zimbabwe; andrewse@who.int 9 Tuberculosis Research and Prevention Center NGO, Yerevan 0040, Armenia; haykdav@gmail.com 10 The International Union against Tuberculosis and Lung Disease, 68 Boulevard Saint Michel, 75006 Paris, France; philip.owiti@theunion.org 11 National Public Health & Reference Laboratory Ghana Health Service, Accra P.O. Box 300, Ghana; opared_60@yahoo.co.uk 12 National Food Safety/AMR Reference Laboratory for Animal Health (Terrestrial & Aquatic Animals), Veterinary Services, Accra P.O. Box M 161, Ghana; boikikimoto@gmail.com 13 Centre for Zoonoses and Environmental Microbiology, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands; heike.schmitt@rivm.nl 14 WHO Collaborating Centre for Risk Assessment of Pathogens in Food and Water at the National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands Funding Information: This SORT IT AMR Programme was funded by National Institute of Health Research, Department of Health & Social Care of the United Kingdom and supported by implementing partners. Acknowledgments: This research was conducted through the Structured Operational Research and Training Initiative (SORT IT), a global partnership coordinated by TDR, the Special Programme for Research and Training in Tropical Diseases at the World Health Organization (TDR). The specific SORT IT program that led to these publications included a partnership of TDR with WHO Country offices of Ghana, Sierra Leone and Uganda and was implemented along with The Tuberculosis Research and Prevention Center Non-Governmental Organization, Armenia; The International Union Against Tuberculosis and Lung Diseases, Paris and South East Asia offices; Institute of Tropical Medicine, Antwerp, Belgium; Sustainable Health Systems, Freetown, Sierra Leone; M?decins Sans Fronti?resLuxembourg (LuxOR) Centre National de Formation et de Recherche en Sant? Rurale de Maferinyah, Guinea; BahirDar University BahirDar, Ethiopia and the University of Salford, United KingdomWe also thank Government of the United Kingdom, using UK aid funding through the Fleming Fund, for funding the development and implementation of the Tricycle Protocol; the Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR), the WHO Department of Surveillance Prevention and Control of AMR for their lead roles and numerous support; and the WHO Ghana country office for all their ongoing support. The geospatial and mapping portions of this publication. Funding Information: Acknowledgments: This research was conducted through the Structured Operational Research and Training Initiative (SORT IT), a global partnership coordinated by TDR, the Special Programme for Research and Training in Tropical Diseases at the World Health Organization (TDR). The specific SORT IT program that led to these publications included a partnership of TDR with WHO Country offices of Ghana, Sierra Leone and Uganda and was implemented along with The Tuberculosis Research and Prevention Center Non-Governmental Organization, Armenia; The International Union Against Tuberculosis and Lung Diseases, Paris and South East Asia offices; Institute of Tropical Medicine, Antwerp, Belgium; Sustainable Health Systems, Freetown, Sierra Leone; Médecins Sans Frontières-Luxembourg (LuxOR) Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Guinea; BahirDar University BahirDar, Ethiopia and the University of Salford, United KingdomWe also thank Government of the United Kingdom, using UK aid funding through the Fleming Fund, for funding the development and implementation of the Tricycle Protocol; the Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR), the WHO Department of Surveillance Prevention and Control of AMR for their lead roles and numerous support; and the WHO Ghana country office for all their ongoing support. The geospatial and mapping portions of this publication. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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