Prevalence of Resistant Enterobacterales, in Particular ESBL-Producing Escherichia coli in Hospital Wastewater Discharged into the Environment: Study of the Abidjan District, Côte d’Ivoire
CISSE Souleymane *
Biobank, Biological Resources Center, Abidjan, Pasteur Institute of Côte d'Ivoire, Côte d'Ivoire.
KONAN Kouadio Fernique
Bacteriology-Virology, Unit of Antibiotics, Natural Substances and Monitoring of Resistance of Micro-Organisms to Anti-Infectives, Abidjan, Pasteur Institute of Côte d'Ivoire, Côte d'Ivoire.
OUATTARA Mohamed Baguy
Laboratory Input Production Unit, Abidjan, Pasteur Institute of Côte d'Ivoire, Côte d'Ivoire.
DIANE Maxime
Biobank, Biological Resources Center, Abidjan, Pasteur Institute of Côte d'Ivoire, Côte d'Ivoire.
KINTOSSOU Ambroise
Biobank, Biological Resources Center, Abidjan, Pasteur Institute of Côte d'Ivoire, Côte d'Ivoire.
MONEY Marcelle
Biobank, Biological Resources Center, Abidjan, Pasteur Institute of Côte d'Ivoire, Côte d'Ivoire.
N'GUESSAN Felix
Biobank, Biological Resources Center, Abidjan, Pasteur Institute of Côte d'Ivoire, Côte d'Ivoire.
*Author to whom correspondence should be addressed.
Abstract
Aims: Hospital effluent constitutes a reservoir for antibiotic-resistant bacteria. In particular, Gram-negative bacteria carrying several antibiotic resistance genes. This study was to evaluate the prevalence of antibiotic-resistant Enterobacterales and ESBL Escherichia coli in hospital effluents.
Methodology: In total, 112 wastewater samples from 4 hospital sites were collected and examined during 2020 at the Pasteur Institute of Côte d’ivoire. Enumeration of total Enterobacterales was carried out on McConkey agar. McConkey agar was supplemented with 4 mg/l ceftazidime to detect resistant Enterobacterales. Antibiotic-resistant Escherichia coli were identified using MALDI-TOF MS. The production of ESBL was investigated by synergy tests on Mueller-Hinton agar.
Results: The results indicate a prevalence of resistant Enterobacterales varied between 4.6% and 2.6% with an average of 3.9%. A proportion of 69.2% of resistant Enterobacterales were strains of Escherichia coli. ESBL Escherichia coli represented a rate of 32.7% among resistant Enterobacterales. A rate of 47.3% of resistant Escherichia coli strains produced an ESBL. It appears from this study that the phenomenon of multi-resistance is undoubtedly present in bacteria isolated from hospital effluents, because the Enterobacterales isolated from these waters are mainly strains of ESBL-producing Escherichia coli.
Conclusion: Resistant Enterobacterales and particularly ESBL-producing Escherichia coli present in hospital effluents released without treatment into the environment are likely to cause public health problems. These bacteria should be considered environmental pollutants.
Keywords: Antibiotics, Enterobacteriaceae, Escherichia coli, resistance, ESBL, hospital effluent