Phenotypic Characterization and Antibiograms of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolated at the Human-Animal-Environment Interface Using a One Health Approach Among Households in Wakiso District, Uganda

Abstract

Background The occurrence of extended spectrum beta-lactamase (ESBL) producing bacteria such as Escherichia coli has increasingly become recognized beyond hospital settings. Resistance to other types of antibiotics limits treatment options while the existence of such bacteria among humans, animals, and the environment is suggestive of potential zoonotic and reverse-zoonotic transmission. This study aimed to establish the antibiotic susceptibility profiles of the ESBL-producing Escherichia coli (ESBL-EC) from human, animal, and environmental isolates obtained among farming households within Wakiso district using a One Health approach. Methods A total of 100 ESBL-EC isolates from humans 35/100 (35%), animals 56/100 (56%), and the environment 9/100 (9%) were tested for susceptibility to 11 antibiotics. This was done using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed in STATA ver. 16 and graphs were drawn in Microsoft excel ver. 10. Results Most of the ESBL-EC isolates (98%) were resistant to more than two antibiotics. ESBL-EC isolates were most susceptible to meropenem (MEM) (88.0%), and imipenem (82.0%) followed by gentamicin (72%). ESBL-EC isolates from humans were most susceptible to meropenem (MEM) followed by imipenem (IPM)> gentamicin (CN)> ciprofloxacin (CIP). Animal samples were more susceptible to MEM, IPM, and CN but were highly resistant to cefotaxime (CTX)> cefepime (FEP)>other antibiotics. Multidrug resistance (MDR) was mostly reported among households keeping goats under intensive husbandry practices. Seven percent of the isolates exhibited carbapenem resistance while 22% showed aminoglycoside resistance. Similar resistance patterns among humans, animals, and environmental samples were also reported. Conclusion Our study provides baseline information on non-hospital-based MDR caused by ESBL-EC using a One Health approach. ESBL-EC isolates were prevalent among apparently healthy community members, animals, and their environment. It is important to conduct more One Health approach studies to generate evidence on the drivers, resistance patterns, and transmission of ESBL-producing organisms at the human-animal-environmental interface.

Carbapenem Resistance in Animal-Environment-Food from Africa: A Systematic Review, Recommendations and Perspectives

“… 10/102 (9.7) bla IMP , bla VIM NA [ 156 ] NA Rabbits E. coli 16/39 (41) bla IMI , bla VIM NA [ 157 ] Uganda 2016–2017 Cattle, pig, layer chicken E. coli 0 bla ACT-1 , bla ACT-28 , bla ACT-12 , bla TEM-87 NA [ 158 ] 2018–2019 Rectal swabs from cattle E. coli, Klebsiella spp., S. fonticola, K. ascorbate, Enterobacter spp. 14/120 (11.7) NA NA [ 159 ] 2018–2020 Stool samples from livestock (sheep, goats, cattle, chicken, swine) E. coli 36/96 (37.5) bla KPC NA [ 160 ] 2022 Cow, pig, goat, dog, duck fecal samples, soil, water for domestic use, swabs from animal feeding equipment, doorknobs E. coli 11/65 (16.9) NA NA [ 161 ] NA Hospital sewage E. coli 25 bla VIM , bla KPC , bla NDM ( eae, elt, est, paH, PAI IV536 ) NA ...…”