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. 2023 May 24;9(6):e16538.
doi: 10.1016/j.heliyon.2023.e16538. eCollection 2023 Jun.

Antimicrobial resistant Escherichia coli prevalence in freshwaters in Belgium and human exposure risk assessment

L Crettels  1   2 , L Champon  1 , N Burlion  1 , E Delrée  1 , C Saegerman  3 , D Thiry  2
Affiliations

Antimicrobial resistant Escherichia coli prevalence in freshwaters in Belgium and human exposure risk assessment

L Crettels et al. Heliyon. .

Abstract

The objective of this work was to evaluate the antimicrobial resistant (AR) E. coli prevalence in recreational waters in Belgium and to assess the exposure risk for bathers. Nine stations were sampled during the 2021 bathing season. A total of 912 E. coli strains were isolated and tested by the disk diffusion method in accordance with EUCAST recommendations, including Extended-Spectrum Beta-Lactamase (ESBL) production. AR E. coli were counted at each bathing sites, 24% of strains were resistant to at least one antibiotic and 6% were Multi-Drug Resistant (MDR). A Multiple Antibiotic Resistance (MAR) index was calculated to compare the bathing sites. The Lesse river had the highest MAR index as well as the highest E. coli absolute abundance and the largest number of ESBL-producing E. coli. Conversely, the 3 lakes showed lower E. coli contamination levels and AR rates. A human health risk assessment of exposure to AR E. coli, based on the calculation of measured prevalence, was performed considering four different dose-response model scenarios. The human health risk (Pd) ranged from 10-9 to 0.183 (children). The exposure probabilities were low, except for scenario 3 (E. coli O157:H7), which is the most severe.

Keywords: Antibiotic resistance; Bathing water; Human health exposure risk assessment; Recreational water; Wallonia; Water quality.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Sampling areas of the recreational waters in Belgium. Rivers (5); Lakes (3); Canalized river (1) (ArcMap).
Fig. 2
Fig. 2
E. coli absolute abundance measured by sampling station and/or month.
Fig. 3
Fig. 3
Resistance rates based on antibiotic and culture medium for the 912 E. coli isolated strains (AMC: amoxicillin/clavulanic acid, AMP: ampicillin, CIP: ciprofloxacin, COX: cefotaxim, CXM: cefuroxime, CZD: ceftazidim, ETP: ertapenem, FOS: fosfomycin, CN: gentamicin, MEM: meropenem, NFE: nitrofurantoin, PTZ: piperacillin/tazobactam, SXT: sulfamethoxazole/trimethoprim, TGC: tigecyclin).
Fig. 4
Fig. 4
MAR index calculated by sampling station and month and average MAR index by station.
See this image and copyright information in PMC

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