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20/03/2015

U. D. S., GHANA. Water Quality Assessment Of Swimming Pools And Risk Of Spreading Antibiotic Resistance In Ghana. Courage Kosi Setsoafia Saba, Ph.D. ( Lecturer/Lab. Superintendent ).

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20/03/2015

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  1. U. D. S., GHANA Water Quality Assessment Of Swimming Pools And Risk Of Spreading Antibiotic Resistance In Ghana Courage KosiSetsoafia Saba, Ph.D. (Lecturer/Lab. Superintendent) Department of Biotechnology, Faculty of Agriculture, University for Development Studies (U. D. S.), Tamale, Ghana African Conference on Antibiotic Use and Resistance 20/03/2015 Accra-Ghana

  2. U. D. S., GHANA Order of Presentation • Introduction • Objectives • Materials and Methods • Results • Conclusions • Recommendations Who is winning the antibiotic resistance war: bacteria or Man?

  3. U. D. S., GHANA Introduction • Recreation has a substantial role in the life of the ever increasing population of the world, and when choosing the scene for it, people tend to couple it with water. • One of the cheapest ways of recreating oneself is by the use of nature’s own available water resources like rivers, dams, lakes, seas etc. • To make recreation with water more accessible and convenient, people construct swimming pools in houses, hostels, schools and other public places. Who is winning the antibiotic resistance war: bacteria or Man?

  4. U. D. S., GHANA Introduction cont. B A A constructed swimming pool A “natural“ swimming pool Who is winning the antibiotic resistance war: bacteria or Man?

  5. U. D. S., GHANA Introduction cont. • Man-made water recreational environments are on the boom, but also presenting certain extent of risk of microbiological and chemical contaminations (Barna and Kadar, 2012). • Swimmers are at risk of contracting infectious diseases since the average amount of water swallowed by non-adults and adults during a normal swimming session is approximately 37 ml and 16 ml, respectively (Dufour et al., 2006). • Under application of chlorine will help microorganisms to thrive in the water and over application may lead to toxic effects on swimmers (Martinez and Long, 1995: Bernard et al., 2003). Who is winning the antibiotic resistance war: bacteria or Man?

  6. U. D. S., GHANA Introduction cont. • Some caretakers of swimming pools have little knowledge about the importance of maintaining the pools to meet both the microbiological and physiochemical standards in Ghana. • People with resistance bugs are likely to release some in the pool during swimming, which may be acquired by other swimmers. • There is currently little or no data about infections and outbreak of diseases and antibiotic resistant pattern of organisms in swimming pools in Ghana. Who is winning the antibiotic resistance war: bacteria or Man?

  7. U. D. S., GHANA The One Health Approach to Curb ABR Animals Humans One Health Medical Officers, Veterinarians and other Researchers must WORK TOGETHER to CURB the menace of ABR Environment Who is winning the antibiotic resistance war: bacteria or Man?

  8. U. D. S., GHANA Objectives • To compare the quality of selected swimming pools to international standards. • To determine the physiochemical parameters in the various swimming pools as well as microbial load. • To test for the presence of pathogenic E. coli in the swimming pools • To determine the antibiotic susceptibility levels of isolated E. coli from the swimming pools. Who is winning the antibiotic resistance war: bacteria or Man?

  9. U. D. S., GHANA Materials and Methods Study location • The Eastern Region was chosen due to the higher number of tourists that visit the region. • Due to the higher number of hotels with swimming pools for tourists or holiday makers that visit the region. Accra Eastern Region Who is winning the antibiotic resistance war: bacteria or Man?

  10. U. D. S., GHANA Materials and Methods cont. • A total of Twenty-eight (28) water samples were purposively collected four (4) times from seven different public and private swimming pools in a district over a four-month period (December 2013 to March 2014). • Samples were collected and transported to the laboratory in a flask containing ice cubes for analysis within fifteen minutes. • The sampling sites were designated site A, B, C, D, E, F and G. • The site D is a public pool and open to the general while site E is semi-public. Sites A, B, C, F and G are swimming pools attached to hotels. Who is winning the antibiotic resistance war: bacteria or Man?

  11. U. D. S., GHANA Materials and Methods cont. • Temperature, pH, Electrical conductivity and Turbidity of the swimming pools water were determined in situ using the Pelintest multi-purpose meter. • Membrane filtration technique was employed to determine faecal coliforms and E. coli by culturing them on M-FC Agar and Hi-Chrome E. coli agar respectively. • Total heterotrophic bacteria count was determined by using the pour plating method with nutrient agar. • CHROMagar STEC agar, a specific chromogenic agar for the isolation of Shiga-Toxin producing E. coli isolates was used to detect pathogenic E. coli. • Sorbitol MacConkey agar was used to differentiate E. coli O157:H7 from non-E. coli O157:H7 serotypes. Who is winning the antibiotic resistance war: bacteria or Man?

  12. U. D. S., GHANA Materials and Methods cont. Antibiotic susceptibility test • Antibiotic susceptibility test was performed for all the isolates using the Kirby Bauer disk diffusion method with a visual McFarland. • Seven antibiotic (bioMerieux, España) used include: amoxicillin (25μg), amoxicillin-clavulanate (20/10μg), sulfamethoxazole (25μg), chloramphenicol (30μg), ciprofloxacin (5μg), gentamicin (10μg) and ceftriaxone (30μg). • The susceptibility and resistance of the isolates were determined by using the EUCAST breakpoint for 2014. • Multiple drug resistant isolates were designated as resistance to 3 or more antibiotics. Who is winning the antibiotic resistance war: bacteria or Man?

  13. U. D. S., GHANA Results Table 1. Mean values of the parameters measured form the various swimming pools compared to the WHO limits Who is winning the antibiotic resistance war: bacteria or Man?

  14. U. D. S., GHANA Results • Pathogenic E. coli • Two (2) of the 28 samples taken tested positive for the production of Shiga toxin on CHROMagar STEC agar. • These positive STEC samples were from site D (public pool) and E (semi-public pool). • The two samples were further classified as E. coli O157:H7 due to their inability to ferment sorbitol. Who is winning the antibiotic resistance war: bacteria or Man?

  15. U. D. S., GHANA Results Fig 1. Percentage of susceptibility of isolated E. coli against common antibiotics CRO= Ceftraixone, C= Chloramphenicol, CN=Gentamicin, CIP=Ciprofloxacin, AMC= Amoxiocillin clavulanate, SXT=Sulfamethoxazole and amoxicillin Who is winning the antibiotic resistance war: bacteria or Man?

  16. U. D. S., GHANA Results Table 2. Antibiotic susceptibility results of the two E. coli O157:H7 isolates The two pathogenic Strains are ESBL-producing Strains Who is winning the antibiotic resistance war: bacteria or Man?

  17. U. D. S., GHANA Conclusions • The physicochemical parameters of the sampled swimming pool water samples were generally of standards (Temp., E. C, and free chlorine) except the pH and turbidity values, which were below standards set by WHO. • Faecal coliform and E. coli recorded figures that exceeded the WHO guidelines for recreational waters in all the swimming pools. • We isolated two pathogenic and highly resistant strains of E. coli O157:H7 from two of the public swimming pools. • Although the general resistances of the isolated organisms were low against the antibiotics used, there were resistant to clinically relevant antibiotics, which pose a risk to swimmers and public healthcare in Ghana. Who is winning the antibiotic resistance war: bacteria or Man?

  18. U. D. S., GHANA Conclusions • We also isolated phenotypically, ESBL-producing E. coli strain from swimming pools in Ghana. • Twenty one percent (21%) of the isolates in this study exhibited multiple resistance to antibiotics. Who is winning the antibiotic resistance war: bacteria or Man?

  19. Recommendations • The government agency responsible for ensuring the sanity of swimming pool must organise regular training for caretakers of swimming pools and invite experts to talk to them about ABR. • We must all endeavor to promote the one health approach to curb ABR. Who is winning the antibiotic resistance war: bacteria or Man?

  20. Acknowledgements • Saviour Kojo Tekpor, Bsc Department of Ecotourism and Environmental Management, Faculty of Renewable Natural Resources, University for Development Studies, Tamale, Ghana • Bruno Gonzalez Zorn, DVM, Ph.D. Complutense University of Madrid, Faculty of Veterinary Medicine, Spain U. D. S., GHANA Who is winning the antibiotic resistance war: bacteria or Man?

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