uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Association between Hospital Waste and the House Crow (Corvus splendens) in the Dissemination of Antibiotic Resistance and the Epidemic Escherichia coli Clone O25b-ST131 in Bangladesh
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Björn Olsen)
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Multiresistant bacteria constitute a serious health risk. In order to investigate the environmental contamination of antibiotic resistance in areas with poor waste management in Bangladesh, fecal samples from 238 house crows living in the surroundings of two major hospitals were screened for members of the Enterobacteriaceae family with extended spectrum beta-lactamase (ESBL)-production. These were compared with 31 ESBL-producing patient isolates, and the susceptibility of E. coli isolates was tested. Without selective pressure, 65.8% of the E. coli isolates from crows were resistant to one or more of 13 antibiotics, and 39.1% were multiresistant. The highest resistance rates were against tetracycline (52.2%), trimethoprim-sulphamethoxazole (43.5%), nalidixic acid (39.8%) and ampicillin (33.5% ). Fifty-nine percent of the crows were ESBL-carriers, and the isolates harbored CTX-M-1, CTX-M-15, CTX-M-55, CTX-M-79 or CTX-M-14-like genes. Two thirds of these ESBL-producers were multi-drug resistant. The ESBL-producing isolates from patients showed a higher rate of resistance compared with the ESBL-producers from crows. One hundred percent were multi-drug resistant, and most common was resistance to ciprofloxacin (93.3%) and trimethoprim-sulphamethoxazole (60%). The corresponding figures for ESBL-producing crow isolates were 41.3% and 57.3%. The crows and patients shared the epidemic E. coli clone O25b-ST131, which carried CTX-M-15 and CTX-M-14-like enzymes. Dissemination of ESBL-producing Klebsiella pneumoniae was also observed among the crows. In conclusion, the Bangladeshi house crow is the bird with the highest carriage rate of ESBL-producing bacteria observed so far. Their scavenging behavior at poorly managed hospital waste dumps, makes them into both reservoirs and active spreaders of antibiotic resistance into the environment. Nationwide programs are necessary to both improve the management of hospital waste and sewage and the control of the antibiotic usage to prevent further environmental contamination. 

Keyword [en]
House crow, E. coli, antibiotic resistance, blaCTX-M-15, ESBL, O25b-ST131
National Category
Veterinary Science Microbiology in the medical area
Research subject
Epidemiology; Medical Science
Identifiers
URN: urn:nbn:se:uu:diva-199627OAI: oai:DiVA.org:uu-199627DiVA: diva2:620609
Funder
Formas
Available from: 2013-05-08 Created: 2013-05-08 Last updated: 2013-05-27
In thesis
1. Antimicrobial Resistance and Production of Extended Spectrum Beta-Lactamases in Enterobacteriaceae from Birds in Bangladesh
Open this publication in new window or tab >>Antimicrobial Resistance and Production of Extended Spectrum Beta-Lactamases in Enterobacteriaceae from Birds in Bangladesh
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The dissemination of members of the Enterobacteriaceae family with extended spectrum beta-lactamases (ESBLs) and metallo-beta-lactamases (MBLs) has become a global concern. ESBLs and MBLs have been reported in humans, domestic animals, wildlife and the environment, and their isolation frequencies are increasing rapidly worldwide.  Most studies have been performed in developed countries and quite few in developing countries, where the antibiotic consumption is often poorly controlled. To explore the environmental contamination of antibiotic resistance in Bangladesh, and of ESBLs and MBLs in particular, fecal samples from poultry and wild birds were studied in this thesis.

Samples were collected from both sick birds (poultry having Escherichia coli infections) and healthy birds (free-range poultry, seagulls and crows) residing in different environmental niches. Samples from patients and fresh/sea water were included, to follow the chain of antibiotic resistance in bacteria from humans to the environment. Information regarding the antibiotic usage in poultry production was also collected. The susceptibility of avian E. coli isolates cultured with and without selective pressure was tested against antibiotics commonly used in human and veterinary medicine in Bangladesh. Special attention was paid to ESBL-producing isolates, which were further characterized genetically.

The results of the studies showed that E. coli isolates from commercial poultry, free-range poultry, gulls and crows were resistant to several classes of antibiotics, and that the level and spectrum of antibiotic resistance varied between different bird populations. There was no NDM-producer found among the birds, but ESBL-producing Enterobacteriaceae could be found in up to 59% of the crows, the birds with the highest carriage rate of multiresistant  Enterobacteriaceae of all bird species studied. The most common ESBL-type was CTX-M-15, which also is the most common in the human population in Bangladesh. Birds also shared clinically important sequence types with humans, including E. coli clone O25b-ST131.

In conclusion, ESBL-producing bacteria with multiresistance are easily spread to wild birds. Their opportunistic feeding behavior at poorly managed hospital waste dumps and nearby water bodies makes them into both reservoirs and active spreaders. The high level of antibiotic resistant and ESBL-producing bacteria in the bird population of Bangladesh is worrying, and there is no easy solution in sight. Nationwide programs are necessary to both improve the management of hospital waste and sewage and the control of the antibiotic usage to prevent further environmental contamination. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 75 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 911
Keyword
Antimicrobial Resistance, ESBL, CTX-M, NDM, Poultry, Wild birds, E. coli, Bangladesh, Enterobacteriaceae, Antibiotics
National Category
Microbiology in the medical area
Research subject
Epidemiology; Microbiology; Medical Science
Identifiers
urn:nbn:se:uu:diva-199686 (URN)978-91-554-8691-4 (ISBN)
Public defence
2013-06-12, Hörsalen, Klinisk mikrobiologi, Dag Hammarskjöldsväg 17 ingång D1, Uppsala, 09:00 (English)
Opponent
Supervisors
Note

Time of defence has been changed to 09:00 am on 2013-05-27

Available from: 2013-05-22 Created: 2013-05-13 Last updated: 2013-08-30

Open Access in DiVA

No full text

Authority records BETA

Hasan, Badrul

Search in DiVA

By author/editor
Hasan, Badrul
By organisation
Department of Medical Sciences
Veterinary ScienceMicrobiology in the medical area

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 474 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf