Linking humans and the environment in the spread of antimicrobial resistant <i>E. coli</i> in a rural community of South Africa. A One Health case study.

Abstract

Antimicrobial resistance is a global health crisis that threatens vulnerable populations in low-resource settings. Using the One Health approach, this study investigated AMR <i>in E. coli</i> among children under 5 years old and their surrounding living environments in Lwamondo village, South Africa. From 47 paired stool and soil samples, a total of 117 and 94 <i>E. coli</i> strains were isolated. Isolates were confirmed by PCR, and antimicrobial susceptibility testing was performed against commonly used antibiotics, followed by PCR for β-lactam resistance genes. Phenotypic β-lactam resistance was observed in children under 3 years of age (27-56%). Chloramphenicol was the most frequently detected antibiotic in both stool (41%) and soil (50%) isolates, followed by amoxicillin (27% in stool, 32% in soil). The <i>blaTEM</i> was the most predominant gene, detected in both the stools (36%) and soil (26%) isolates. Phylogenetic analysis revealed that the majority of AMR <i>E. coli</i> belong to Group A. The findings of this study demonstrate the interconnectedness between humans and their surrounding environment, which can both serve as important reservoirs for the transmission of AMR <i>E. coli</i>.