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
(English)Manuscript (preprint) (Other academic)
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.
House crow, E. coli, antibiotic resistance, blaCTX-M-15, ESBL, O25b-ST131
Veterinary Science Microbiology in the medical area
Research subject Epidemiology; Medical Science
IdentifiersURN: urn:nbn:se:uu:diva-199627OAI: oai:DiVA.org:uu-199627DiVA: diva2:620609