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Prevalence of Extended-Spectrum β-Lactamase-Producing Escherichia coli , Klebsiella pneumoniae and Enterobacter cloacae in Wastewater Effluent in Blantyre, Malawi

Affiliation
Pathology Department, Kamuzu University of Health Sciences, Blantyre 312200, Malawi;(C.M.);(E.M.);(H.H.T.);(J.C.);(J.M.);(R.S.M.)
Ibrahim, Edna;
Affiliation
Pathology Department, Kamuzu University of Health Sciences, Blantyre 312200, Malawi;(C.M.);(E.M.);(H.H.T.);(J.C.);(J.M.);(R.S.M.)
Mkwanda, Charity;
ORCID
0000-0001-9289-3704
Affiliation
Pathology Department, Kamuzu University of Health Sciences, Blantyre 312200, Malawi;(C.M.);(E.M.);(H.H.T.);(J.C.);(J.M.);(R.S.M.)
Masoambeta, Edward;
Affiliation
Scientific Direction, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy;
Scudeller, Luigia;
ORCID
0000-0002-1259-4876
Affiliation
Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium;(T.K.);(S.M.-K.)
Kostyanev, Tomislav;
ORCID
0000-0003-4473-296X
Affiliation
Pathology Department, Kamuzu University of Health Sciences, Blantyre 312200, Malawi;(C.M.);(E.M.);(H.H.T.);(J.C.);(J.M.);(R.S.M.)
Twabi, Hussein H.;
Affiliation
Malawi Liverpool Wellcome Program, Blantyre 312200, Malawi;
Diness, Yohane K.;
Affiliation
Pathology Department, Kamuzu University of Health Sciences, Blantyre 312200, Malawi;(C.M.);(E.M.);(H.H.T.);(J.C.);(J.M.);(R.S.M.)
Chinkhumba, Jobiba;
Affiliation
Pathology Department, Kamuzu University of Health Sciences, Blantyre 312200, Malawi;(C.M.);(E.M.);(H.H.T.);(J.C.);(J.M.);(R.S.M.)
Musaya, Janelisa;
Affiliation
Pathology Department, Kamuzu University of Health Sciences, Blantyre 312200, Malawi;(C.M.);(E.M.);(H.H.T.);(J.C.);(J.M.);(R.S.M.)
Mkakosya, Rajhab S.;
Affiliation
Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium;(T.K.);(S.M.-K.)
Malhotra-Kumar, Surbhi;
Affiliation
Institute for Public Health and Hygiene, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany;
Morel, Chantal M.;
ORCID
0000-0002-3329-5875
Affiliation
School of Science and Technology, Malawi University of Business and Applied Sciences, Blantyre 312200, Malawi;
Kumwenda, Save;
ORCID
0000-0003-2304-886X
Affiliation
Pathology Department, Kamuzu University of Health Sciences, Blantyre 312200, Malawi;(C.M.);(E.M.);(H.H.T.);(J.C.);(J.M.);(R.S.M.)
Msefula, Chisomo L.

Background/Objectives : Wastewater treatment plants (WWTPs) serve as a sink for both antimicrobial residues and bacteria carrying resistant genes, which are later disseminated into the environment, facilitating the spread of antimicrobial resistance. This study investigated the presence of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli (Ec) , Klebsiella pneumoniae (Kp) , and Enterobacter cloacae (Enc) in effluent from WWTP in Blantyre, Malawi, to generate evidence and provide baseline information for interventions. Methods : Selective chromogenic agar was used to identify ESBL-producing bacteria. Results : A total of 288 samples were collected between April 2023 and March 2024, and 97.6% (281/288) yielded one or more presumptive ESBL isolates. Bacterial growth was confirmed as 48.9% Ec (255/522), 33.0% Kp (172/522), and 10.0% Enc (52/522). Antibiotic susceptibility testing showed the highest resistance to ceftriaxone ( Ec , 100.0%; Kp , 98.3%; Enc , 100.0%) and the lowest resistance to meropenem ( Ec , 6.3%, Kp , 1.2%; Enc , 3.8%) among the antibiotics that were tested. Multiple antibiotic resistance phenotypes were observed in 73.1% of the isolates, with the most prevalent phenotype being amoxicillin + clavulanate/cotrimoxazole/doxycycline/ciprofloxacin/gentamicin/azithromycin/ceftriaxone (55, 15.7%). Conclusions : The study demonstrated ongoing environmental contamination with antibiotic-resistant bacteria from sewage effluent. Therefore, the functionality of WWTPs should be improved to minimize the release of these organisms into the environment.

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Editor:
Franco, Carlos M.
Published in:
Antibiotics  
Vol. 14, No. 6 (30.05.2025)
Volume:
14
No.:
6
Date Issued:
30.05.2025
DOI:
10.3390/antibiotics14060562
Language:
English
Type of Resource:
Text
Keywords:
antimicrobial resistance; Enterobacteriaceae; extended spectrum β-lactamases; sewage effluent; wastewater treatment plants
DDC:
610 Medizin und Gesundheit

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