Treating infection from Odaw, Okrudu rivers
Bacteria are found everywhere, while some are harmless others are harmful. When they cause infections, it is usually not a great worry because we can treat them with antibiotics. Over the years, however, antibiotics do not kill bacteria as they used to as a result of their misuse and overuse. They have developed defensive mechanisms to make them resistant to antibiotics. Extended-spectrum beta-lactamases (ESBLs) for instance are enzymes produced by certain types of bacteria which can breakdown the active ingredients in many common antibiotics, making them ineffective and resistant. When E. coli producing this enzyme (ESBL-Ec) ends up in man, they cause difficult-to-treat infections as they are resistant to almost all antibiotics available in Ghana.
In this article, evidence is provided of sources of such resistance bacteria from the environment. This study forms part of surveillance carried out following a WHO protocol developed to study such phenomenon in three major components (humans, animals and the environments dubbed the One Health Approach). A team of scientists from the Council for Scientific and Industrial Research – Water Research Institute carried out the environmental aspect of this study.
What we did
A total of 100 water samples were fetched from four main points of the well-known Odaw River in Accra and Okrudu River in Kasoa over a 12-month period and analyzed at the microbiology laboratory of CSIR-WRI. From each city, water samples were collected from a source representing pre-city impact (upstream) (Figs.1a & 2b) and a downstream point (Figs.1b) further away from the upstream point of the rivers. In addition, two other samples, human and animal wastewater that discharges into these rivers were taken. Concentrations of ESBL-Ec were determined per 100ml (equivalent to half a glass of water) of river water.
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| Fig.1a Upstream Odaw River Accra | Fig.1b Downstream Odaw River Accra | Fig2a Water samplig process from the Odaw river | Fig.2b Upstream Okurudu River Kasoa |
What was found
- In every 100mls counts ranged from 1,000 to 100,000,000 for coliand 3000 to 240,000 for ESBL-Ec.
- As rivers flowed through these cities these counts increased by 100 and in downstream river waters, ESBL-Ec were 10 times greater in Accra compared to Kasoa.
- Levels of coliand ESBL-Ec. detected were between 10 and 100 times above WHO guideline thresholds for irrigation of crops with wastewater.
- Indeed our study shows the feasibility of the WHO Tricycle Protocol in surveying antibiotic-resistant bacteria in water even in low-resource settings.
What it implies and what must be done
- This study suggests that river water may be contributing to the spread of antibiotic resistance among humans and animals through contaminated food and direct contact.
- Carriage of ESBL-Ec among the human population could result in difficult-to-treat infections such as urinary tract and bloodstream infections.
- High faecal contamination of rivers is likely a result of poor disposal of untreated wastewater into the environment.
Undeniably, this is a wake-up call to keep our rivers and waterways clean and it requires a concerted effort from all relevant stakeholders and every citizen of Ghana. There has to be strict enforcement of by-laws on wastewater disposal by the Ministry of Local Government, Environmental Protection Agency, the Ministry of Sanitation and Water Resources etc. In related news, Dredge Master removed over 2 million cubic meters of waste from the Odaw River including lifeless bodies. It is said that the health of humans connects to the health of the environment and clean water is the world’s first and foremost medicine. Immediate action is therefore required to educate people living around the rivers the safe use of these rivers and proper waste disposal practices.
Special acknowledgements to God Almighty, WHO, TDR SORT IT, Ghana’s AMR Platform members, MESTI, CSIR-WRI, my family and all team members of this study. For further reading, kindly visit https://doi.org/10.3390/tropicalmed6020105
Source: Regina Ama Banu – CSIR Water Research Institu
