A waterborne outbreak of multiple diarrhoeagenic Escherichia coli infections associated with drinking water at a school camp

Park, Jungsun; Kim, Jin Seok; Kim, Soojin; Shin, Eunkyung; Oh, Kyunghwan; Kim, Yong‐Hoon; Kim, Cheon Hyeon; Hwang, Min Ah; Jin, Chan; Na, Kyoungin; Liu, Jin; Cho, Enhi; Kang, Byunghak; Kwak, Hyo‐Sun; Seong, Won Keun; Kim, Junyoung

doi:10.1016/j.ijid.2017.09.021

Cited by 61 publications

(43 citation statements)

References 21 publications

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“…The presence of E. coli in the various water sources may spell health hazards such as diarrhoeal diseases which account for a substantial degree of morbidity and mortality in adults and children [20–24]. Control of diarrhoea may require the administration of antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Multidrug-ResistantEscherichia coliIsolated from Drinking Water Sources

Odonkor

Addo

2018

International Journal of Microbiology

109

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The control of infectious diseases is badly endangered by the rise in the number of microorganisms that are resistant to antimicrobial agents. This is because infections caused by resistant microorganisms often fail to respond to conventional treatment, resulting in prolonged illness and greater risk of death. Antimicrobial-resistant bacteria are also present in various water sources. This study therefore sought to document the microbiological quality and antibiograms of bacterial isolates (E. coli strains) from six different water sources in order to determine their safety for human consumption and to provide updated antibiotic data for pragmatic treatment of patients. Bacteria isolation and identification was done using API and conventional methods. Antibiotic susceptibility testing was conducted using the Kirby–Bauer method. Results obtained indicated that all the water sources tested were of poor quality. Bacteria isolated included E. coli, Enterobacter spp., Klebsiella spp., Salmonella typhi, Streptococcus spp., Proteus vulgaris, Vibrio cholera, Shigella spp., Pseudomonas aeruginosa, and Enterococcus faecalis. The prevalence of multidrug-resistant E. coli was 49.48%. E. coli isolates showed high resistance patterns to the tested antibiotics. They were most resistant to penicillin (32.99%), cefuroxime (28.87%), erythromycin (23.71%), and tetracycline (21.45%). In contrast, they were susceptible to nitrofurantoin (93.8%), cefotaxime and amikacin (91.75%), gentamicin (90.7%), nalidixic acid (89.65%), ciprofloxacin (74.2%), chloramphenicol (69.07%), pipemidic acid (65.97%), and cefuroxime (52.58%). Sixty-three percent (63%) of the multidrug-resistant E. coli strains recorded a multiple antibiotic resistance (MAR) index value >0.2. The susceptible antibiotics, especially the nitrofurantoin, are hence recommended in the practical treatment of waterborne bacterial diseases.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Multidrug-ResistantEscherichia coliIsolated from Drinking Water Sources

Odonkor

Addo

2018

International Journal of Microbiology

109

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“…A case study in 2015 reported that 188 patients experienced acute gastrointestinal symptoms after school camp in Korea, wherein these symptoms were caused by diarrheagenic E. coli (DEC) in drinking water. After investigation, the research team indicated that damaged pipeline and inefficient water purification system for bacteria and virus were two primary reasons (Park et al, 2018). Another outbreak of norovirus gastroenteritis in Italy was associated with improper drinking water system caused by an old chlorination device and close proximity to suspected illegal sewage dumping (Giammanco et al, 2018).…”

Section: Occurrence Of Waterborne Pathogensmentioning

confidence: 99%

Detection and occurrence of indicator organisms and pathogens

Motlagh

Yang

2019

Water Environment Research

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This review paper focuses on detection and quantification techniques of indicator organisms that can be used for water quality assessment. The environmental pathogens that are critical to understand and better evaluate water quality are also discussed in this paper. Several recent studies using culture-independent methods such as microbial source tracking, pulsed field gel electrophoresis, mitochondrial DNA, and next generation sequencing to assess various environmental samples and water bodies have been reviewed.

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“…Enterotoxigenic E. coli (ETEC) is the most common serovar of E. coli and is commonly associated with foodborne diarrheal infections during traveling to endemic regions in Africa, Asia, and South America (Diemert 2006;Steffen 2017;Steffen et al 2015). Many studies have illustrated the role of ETEC and other diarrheagenic E. coli strains in the occurrence of diarrheal infections and the emergence of outbreaks in MGs through catering (Kim et al 2017;Ochi et al 2017;Park et al 2018). Approximately 33.3% of the E. coli-positive samples from symptomatic diarrheal cases at Hajj have been identified to contain bla CTX-M-15 and bla NDM genes that are associated with resistance to third-generation cephalosporins (Abd El Ghany et al 2017).…”

Section: Drug-resistant Enteric Infections At Hajjmentioning

confidence: 99%

The Rise of Antimicrobial Resistance in Mass Gatherings

Bokhary¹,

Rashid²,

Hill-Cawthorne³

et al. 2020

Handbook of Healthcare in the Arab World

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Mass gatherings (MGs) are a common human group behavior. Antimicrobial resistance (AMR) is a major public health issue. The Arab world hosts the annual Hajj pilgrimage, a MG with diverse attendees, and the region is also a layover hub for global travels. Although AMR surveillance is still insufficient, the available data on Hajj reveal that the AMR rate is generally high and is increasing each year. Enteric infections are common in Hajj and provide grounds for AMR acquisition and transmission, including emerging resistance to β-lactams. Respiratory infections are a major concern in Hajj, where incidences of outbreaks such as meningococcal disease being documented during the pilgrimage. With the recorded high usage of antimicrobials during Hajj, including mandatory prophylaxis for high-risk travelers and the availability of over-the-counter antimicrobials, the risk of AMR development is likely to increase.

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A waterborne outbreak of multiple diarrhoeagenic Escherichia coli infections associated with drinking water at a school camp

Abstract: This outbreak points to the importance of drinking water quality management in group facilities where underground water is used and emphasizes the need for periodic sanitation and inspection to prevent possible waterborne outbreaks.

Cited by 61 publications

References 21 publications

Prevalence of Multidrug-ResistantEscherichia coliIsolated from Drinking Water Sources

Prevalence of Multidrug-ResistantEscherichia coliIsolated from Drinking Water Sources

Detection and occurrence of indicator organisms and pathogens

The Rise of Antimicrobial Resistance in Mass Gatherings

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