Description
Introduction:
Antimicrobial resistance (AMR) is a global concern, with implications for human, animal, and environmental health. The interconnectedness of these compartments, as highlighted by the World Health Organization's ONE-HEALTH concept, underscores the need to understand the resistance profiles of bacterial isolates in specific environments for effective management. To address this challenge, a study was conducted in Casablanca, Morocco, a city with high anthropogenic and industrial activity, to screen the presence of antibiotic resistance in Escherichia coli (E.coli) and Klebsiella pneumoniae (K.pneumoniae) at different sampling sites: upstream, inside, and downstream of the city.
Material and methods:
From January 2022 to December 2023, a total of 129 nonduplicates environmental enterobacteriae isolates (19 K.pneumoniae and 110 E.coli) obtained from 200 water samples included those recovered from upstream (43), inside the city (43) and downstream water (43) , acrosse the city of Casablanca. A bacterial suspension obtained after incubation of each water sample in the Brain Heart Infusion medium (BHI) (Bio-rad) at 37°C for 4 to 8 hours was subcultured in Brilliance™ UTI Clarity™ Agar (OXOID) which is a non-selective, differential agar which provides presumptive identification using two chromogenic substrates which are cleaved by enzymes produced by E. coli, Enterococcus spp. and coliforms. The identification of isolates was conducted accurately by VITEK® system “BIOMERIEUX”. Antibiotic susceptibility testing was performed on Mueller Hinton agar (Bio-Rad) by disc diffusion method according to EUCAST 2022 guidlines. Storage was performed using conservation agar (Biorad) and kept in +4°C for at least 2 years.
Results:
Results have showed a high prevalence of E.coli with a rate of 85% and lower for K.pneumoniae in the limit of 15%.
The global antibiotic resistance profile including the three compartments is high in penicillin like AMX and AMC, with resistance rates of 79,8% and 20,9% respectively. Sulfamides are the second most affected antibiotics with a resistance of 27,13%. Then fluoroquinolones with resistance of ciprofloxacine and ofloxacine respectives of 24% and 19%. The aminosides are following with rates of 19% for AK, 9% for GN and 7,7 for TOB. Cephalosporines and monobactams are keeping an average action and resistances are 10% for CAZ, CTX and FEP, 5% for FOX and 17% for AZT. The most effective antibiotics are remaining carbapenems with resistance under 1% for IMP and 4% for ERT.
When comparing antibiotic resistance between compartments, we observe a high resistance of 90% for penicillin in water samples isolated inside the city followed by resistance in upstream city with rates of 60% compared to 47% in downstream strains. Resistance to fluoroquinolones and aminosides are constant within the 3 compartments. But when talking to last resort antibiotics the resistance to carbapenems is only found downstream, and lower inside city.
Conclusion:
Antibiotic investigations should also focus on the environmental domain, particularly in areas with human and animal interaction. Deeper researches are envisaged including genotypic characterization to see the transferability and the migration of resistance genes to and from environment.
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