First Detection of Augmentin and Colistin Resistant <i>Cronobacter Sakazakii</i> from a Pharmaceutical Wastewater in South-Western Nigeria

Abstract

Cronobacter sakazakii formerly known as Enterobacter sakazakii, is a bacterium with a rare cause but often fatal infection of the bloodstream and central nervous system. Infants with weakened immune systems, particularly premature infants, are most likely to contact a Cronobacter infection, although the bacteria have caused illnesses in all age groups. Most cases of C. sakazakii infection come from powdered infant formula (PIF) contaminated with the bacterium. Although relatively little information is known about the existence of Cronobacter in the environment, more reservoirs are being identified, such as water, soil and plant material. Wastewaters from 6 pharmaceutical industries located in a southwestern state in Nigeria were sampled and analyzed. Bacteria were isolated using standard methods and species identification was determined by Gram staining, lactose fermentation, oxidase, catalase and Vitek 2. Antibacterial susceptibility to 25 antimicrobial agents was tested by the disc diffusion method and Vitek 2. Fifty nine Gram-negative bacteria were isolated and identified; one was identified as C. sakazakii. The bacterium was susceptible to all antibiotic mentioned but resistant to augmentin (amoxicillin/clavulanate) and colistin which are high potent drugs for the treatment of very stubborn infections. The public health implication of this fact is that this bacterium could be harbouring resistant genes that can be transferred through water ways such as the pharmaceutical wastewaters to bacteria of the same or different species of clinical importance. Therefore, continuous surveillance of the environmental reservoirs of antibiotic resistant bacteria is necessary to prevent their further spread.

The distribution of extended-spectrum Beta-Lactamase genes in Fomites, healthcare workers, and patients from two hospitals in Lagos state, Nigeria

“…Colistin a last-resort antibiotic showed a resistance of 43.6% which is an increase compared to the report of Obasi et al, (2018) but not up to that of Otokunefor et al, (2019) that recorded 60% colistin resistance in Port Harcourt, Nigeria. This shows a worrisome spread of colistin resistance in Nigeria.…”

Foodborne pathogens in Africa: Understanding Cronobacter sakazakii

“…The study proved to be the first published work on the contamination of PIF with C. sakazakii from Abidjan [47]. Also, the presence of C. sakazakii isolate from pharmaceutical industries wastewaters confirmed the prevalence of C. sakazakii in Nigeria's ecosystem [44].…”

“…Despite global research to determine C. sakazakii prevalence, its epidemiology remains incomplete and poorly understood [42]. Given that C. sakazakii is ubiquitous in animate (man, animals) and inanimate (soil, water, plants) environments, it is not unusual that C. sakazakii has been isolated from a variety of foods as well as animal and vegetable sources of food products [43], though little is known about Cronobacter existence in their various environments [44]. The most common food implicated in Cronobacter infection globally is PIF [12].…”

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“…Infants, elders, pregnant women, and people who have debilitated immune systems are susceptible populations to foodborne diseases [23]. For example, Cronobacter sakazakii is one of life-threatening bacterium for immunocompromised, low weight individuals and premature infants whose age is less than 28 days [3,[24][25][26][27][28][29]. The infection caused by Cronobacter can be serious for older people and for people whose immune systems are weakened by other illnesses or conditions [30].…”