An African perspective on the prevalence, fate and effects of carbapenem resistance genes in hospital effluents and wastewater treatment plant (WWTP) final effluents: A critical review

Abstract

This article provides an overview of the antibiotic era and discovery of earliest antibiotics until the present day state of affairs, coupled with the emergence of carbapenem-resistant bacteria. The ways of response to challenges of antibiotic resistance (AR) such as the development of novel strategies in the search of new antibiotics, designing more effective preventive measures as well as the ecology of AR have been discussed. The applications of plant extract and chemical compounds like nanomaterials which are based on recent developments in the field of antimicrobials, antimicrobial resistance (AMR), and chemotherapy were briefly discussed. The agencies responsible for environmental protection have a role to play in dealing with the climate crisis which poses an existential threat to the planet, and contributes to ecological support towards pathogenic microorganisms. The environment serves as a reservoir and also a vehicle for transmission of antimicrobial resistance genes hence, as dominant inhabitants we have to gain a competitive advantage in the battle against AMR.

Occurrence, identification, and antibiogram signatures of selected Enterobacteriaceae from Tsomo and Tyhume rivers in the Eastern Cape Province, Republic of South Africa

“…The presence of these key ESBL genes in clinical and environmental contexts have been previously described among Klebsiella spp. in South African and international isolates [89][90][91][92]. Since the isolates did not display full resistance to carbapenems and consequently did not harbour any of the carbapenemases genes, it was assumed that these could be kept as reserve drugs to treat infections caused by Klebsiella spp.…”

Ecotoxicity of hospital wastewaters and their impact on bacterial multi-drug resistance: a review

“…However, 800,000 deaths could be avoided per year with good management of these effluents according to the report of the seventy-second World Health Assembly [16]. Indeed, metabolites of degradation residues from products used for health care, and pathogenic germs in aquatic environments largely contribute to the death rates [34][35][36][37][38][39]. In most African countries, problems regarding both hospital wastewater quantity and quality.…”

Comparison of the elimination effectiveness of tetracycline and AmpC β-lactamase resistance genes in a municipal wastewater treatment plant using four parallel processes

“…3 suggest that biological treatments could more effectively reduce the abundance of tet genes and AmpC β-lactamase genes, which might be related to the high efficiency of WWTPs in reducing the bacterial population (Su et al 2014). AmpC βlactamase plays an important role in hydrolyzing all β-lactam antibiotics and contains two types of resistance mechanisms, i.e., chromosomal mediated and plasmid mediated (Mohamudha et al 2012;Korzeniewska, Harnisz 2013), except cefepime and carbapenems (Maravić et al 2013;Ebomah and Okoh. 2020).…”