Occurrence of Extended Spectrum Beta Lactamase (ESBL) Producers, Quinolone and Carbapenem Resistant Enterobacteriaceae Isolated from Environmental Samples along Msimbazi River Basin Ecosystem in Tanzania

Abstract

We conducted environmental surveillance of antimicrobial resistance (AMR) bacteria in the Msimbazi river basin in Tanzania to determine the occurrence of extended-spectrum β-lactamase (ESBL)-producing, carbapenem resistant Enterobacteriaceae (CRE) and quinolone resistant Escherichia coli and Klebsiella spp. A total of 213 Enterobacteriaceae isolates were recovered from 219 samples. Out of the recovered isolates, 45.5% (n = 97) were Klebsiella pneumoniae and 29.6% (n = 63) were Escherichia coli. K. pneumoniae isolates were more resistant in effluent (27.9%) compared to the E. coli (26.6%). The E. coli had a higher resistance in river water, sediment and crop soil than the K. pneumoniae (35 versus 25%), respectively. Higher resistance in K. pneumoniae was found in nalidixic acid (54.6%) and ciprofloxacin (33.3%) while the E. coli isolates were highly resistant to ciprofloxacin (39.7%) and trimethoprim/sulfamethoxazole (38%). Resistance increased from 28.3% in Kisarawe, where the river originates, to 59.9% in Jangwani (the middle section) and 66.7% in Upanga West, where the river enters the Indian Ocean. Out of 160 E. coli and K. pneumoniae isolates, 53.2% (n = 85) were resistant to more than three classes of the antibiotic tested, occurrence being higher among ESBL producers, quinolone resistant and carbapenem resistant strains. There is an urgent need to curb environmental contamination with antimicrobial agents in the Msimbazi Basin.

Magnitude of Extended-Spectrum Beta-Lactamase-Producing Gram-Negative and Beta-Lactamase-Producing Gram-Positive Pathogens Isolated from Patients in Dar es Salaam, Tanzania: A Cross-Sectional Study

“…These ESBL organisms could easily spread from the vendors to the meat and, finally, to consumers in the food chain. ESBL organisms found in environmental samples along the Msimbazi River Basin Ecosystem in Tanzania were resistant to more than three classes of the antibiotics tested [ 5 ]. In another study in an urban study site in Keko Machungwa, part of the most significant unplanned and under-serviced settlement in Temeke district, Dar es Salaam, Tanzania, ESBL-producing Enterobacteriaceae were confirmed in 24.3% of the 70 latrine samples [ 7 ].…”

“…It is well recognized that E. coli's high agility in exchanging genetic information with various species is not uncommon. The increased presence of E. coli in nature can partly explain this finding [ 5 ]. The percentage of isolates expressing ESBL production is variable, as revealed by several previous studies: in the United States is 9.2%, Argentina (48%), France (11.4%), and India (68%), which is relatively similar to our findings.…”

“…Studies conducted between 2001 and 2020 in Tanzania show a substantial proportion of ESBL-producing isolates in ICUs in some hospitals and some fatal cases of pediatric septicemia due to ESBL producers [ 3 , 12 , 13 ]. In Tanzania, the prevalence of ESBL producers could be aggravated by the fact that the majority of the livestock, and particularly poultry keepers, use antibiotics to treat their flock whenever they get ill before seeking other specialized veterinary care [ 5 , 14 ].…”

National Antibiotics Utilization Trends for Human Use in Tanzania from 2010 to 2016 Inferred from Tanzania Medicines and Medical Devices Authority Importation Data

“…We cannot rule out that some medicines, such as tetracyclines may have been used in veterinary farming. Indeed, some samples obtained from animals and the environment in the Msimbazi River basin in Tanzania indicated high resistance levels to some antibiotics classes used by humans [40,[42][43][44][45], such as tetracycline, nalidixic acid, ampicillin, and trimethoprim and sulfamethoxazole. These studies also revealed that farmers purchase these medicines without veterinary prescriptions [40,[42][43][44][45].…”

Occurrence of EBSL and quinolone resistance genes among Escherichia coli and Klebsiella pneumoniae isolated from poultry, domestic pigs and environment in the Msimbazi River Basin in Tanzania

“…The Msimbazi river basin in Tanzania has a myriad of human activities making it a hot spot for the spread AMR bacteria and resistant genes between human-animal-environmental compartments [39][40][41][42]. Phenotypic studies conducted in the basin showed very high levels of ESBL producing and quinolone resistant strains among bacteria isolated from poultry, domestic pigs and the environment [43,44]. However, all these studies were limited to phenotypic screening of antibiotic resistant pathogens and none focused on the occurrence of resistant genes.…”