AiM  Vol.9 No.5 , May 2019
Occurrence of Highly Resistant Microorganisms in Ruai Wastewater Treatment Plant and Dandora Dumpsite in Nairobi County, Kenya
Abstract: Wastewater treatment plants and solid dump sites act as potential reservoirs of highly resistant bacterial strains. This study presents information on the patterns of antimicrobial resistance among pathogenic bacteria in the sewage treatment plants and solid dump site in Nairobi County, Kenya. We employed standard microbiological methods to isolate and identify bacteria from these selected sites. Members of Escherichia, Klebsiella, Serratia, Shigella, Pseudomonas, Citrobacter spp, Enterobacter, Salmonella, Staphylococcus, Bacillus, Yersinia, Vibro cholera, Providencia, Morganella and Proteus spp were isolated. Escherichia and Klebsiella recorded the highest occurrence at 13.9% and 10.3% in wastewater. Shigella, Serratia Citrobacterfreundii, Pseudomonas, Staphylococcus, Escherichia and Klebsiella recorded the highest level of occurrence at 15.1%, 14.1%, 12%, 11%, 10.4%, 10.3%, and 8.3% in dumpsite respectively. Drug sensitivity using the Disc diffusion method showed that Ampicillin, Ceftazidime, Cefotaxime, Amoxicillin, and Cefepime had the highest levels of inactivity at (68.5%, 89.5%), (64.2%, 87%), (54.5%, 80.2%), (52%, 74%) and (49.1%, 72.4%) respectively while Levofloxacin and Gentamicin showed the smallest level of antibiotic resistance at (4.8%, 4.7%) and (4.2%, 2.6%) in both sites. Members of Escherichia, Klebsiella, Proteus vulgaris, Salmonella, Pseudomonas, Shigella and Serratia showed the highest level of ESBLs production at 28.9%, 18.4%, 15.8%, 10.5%, 7.9%, 7.9%, 7.9% and 7.9% in the wastewater whereas Shigella, Escherichia, Serratia, Pseudomonas, Klebsiella, and Proteus vulgaris showed the highest level ESBLs production at 45.5%, 10.9%, 9.1%, 9.1%, 7.3% and 7.3% from the dump site. All the antibiotics tested except for Gentamicin, Chloramphenicol and Ciprofloxacin differed significantly in terms of resistance levels (p < 0.05). The study concluded that, wastewater treatment plant and dump sites bear heavy burdens of potentially virulent resistant bacterial strains which may constitute major public health hazards to scavengers and those living near these sites. There is need therefore to educate people on the use of appropriate protective materials and the settlement patterns of individuals and communities near these sites.
Cite this paper: Song’oro, E. , Nyerere, A. , Magoma, G. and Gunturu, R. (2019) Occurrence of Highly Resistant Microorganisms in Ruai Wastewater Treatment Plant and Dandora Dumpsite in Nairobi County, Kenya. Advances in Microbiology, 9, 479-494. doi: 10.4236/aim.2019.95029.

[1]   Maron, D.F. (2016) Superbug Explosion Triggers UN General Assembly (UNGA) meeting. Scientific America.

[2]   Perovic, O. and Schultz, C. (2016) Stepwise Approach for Implementation of Antimicrobial Resistance Surveillance in Africa. African Journal of Laboratory Medicine, 5, 482-488.

[3]   OIE (2015) Fact Sheet on Antimicrobial Resistance.

[4]   WHO (2015) Global Action Plan on Antimicrobial Resistance.

[5]   O’Neill, J. (2016) Tackling Drug-Resistant Infections Globally: Final Report and Recommendations.

[6]   WHO (2014) Antimicrobial Resistance. In: Global Report on Surveillance, Geneva, Switzerland.

[7]   Liu, Y.Y., Wang, Y., Walsh, T.R., Yi, L.X., Zhang, R., Spencer, J., Doi, Y., Tian, G., Dong, B., Huang, X., et al. (2016) Emergence of Plasmid-Mediated Colistin Resistance Mechanism MCR-1 in Animals and Human Beings in China: A Microbiological and Molecular Biological Study. The Lancet Infectious Diseases, 16, 161-168.

[8]   Xavier, B.B., Lammens, C., Ruhal, R., Kumar-Singh, S., Butaye, P., Goossens, H. and Malhotra-Kumar, S. (2016) Identification of a Novel Plasmid-Mediated Colistin- Resistance Gene, mcr-2, in Escherichia coli, Belgium, June 2016. Eurosurveillance, 21, pii=30280.

[9]   WHO (2015) World Malaria Report. WHO, Switzerland, Geneva.

[10]   Harbarth, S. and Samore, M.H. (2005) Antimicrobial Resistance Determinants and Future Control. Emerging Infectious Diseases, 11, 794-801.

[11]   Do, N.T., Ta, N.T., Tran, N.T., Than, H.M., Vu, B.T., Hoang, L.B., van Doorn, H.R., Vu, D.T., Cals, J.W., Chandna, A., et al. (2016) Point-of-Care C-Reactive Protein Testing to Reduce Inappropriate Use of Antibiotics for Non-Severe Acute Respiratory Infections in Vietnamese Primary Health Care: A Randomised Controlled Trial. The Lancet Global Health, 4, E633-E641.

[12]   The World Bank (2015) World Development Indicators.

[13]   Ashley, E., Lubell, Y., White, N. and Turner, P. (2011) Antimicrobial Susceptibility of Bacterial Isolates from Community-Acquired Infections in Sub-Saharan Africa and Asian Low and Middle Income Countries. Tropical Medicine & International Health, 16, 1167-1179.

[14]   Leopold, S., ven Leth, F., Terekegn, H. and Schultsz, C. (2014) Antimicrobial Drug Resistance among Clinically Relevant Bacterial Isolates in Sub-Saharan Africa: A Systematic Review. Journal of Antimicrobial Chemotherapy, 69, 2337-2353.

[15]   WHO (2015) Worldwide Country Situation Analysis: Response to Antimicrobial Resistance. World Health Organization, Geneva.

[16]   Bahwere, P., Levy, J., Hennart, P., et al. (2001) Community-Acquired Bacteraemia among Hospitalized Children in Rural Central Africa. International Journal of Infectious Diseases, 5, 180-188.

[17]   Reddy, E., Shaw, A.V. and Crump, J.A. (2010) Community-Acquired Bloodstream Infections in Africa: A Systematic Review and Meta-Analysis. The Lancet Infectious Diseases, 10, 417-432.

[18]   Seale, A., Davies, M., Anampiu, K., et al. (2016) Invasive Group A Streptococcus Infection among Children, Rural Kenya. Emerging Infectious Diseases, 22, 224-232.

[19]   Kissoon, N. and Uyeki, T. (2016) Sepsis and the Global Burden of Disease in Children. JAMA Pediatrics, 170, 107-108.

[20]   Omulo, S., Thumbi, S.M., Njenga, M.K. and Call, D.R. (2015) A Review of 40 Years of Enteric Antimicrobial Resistance Research in Eastern Africa: What Can Be Done Better? Antimicrobial Resistance & Infection Control, 4, 1.

[21]   Eager, H., Swan, G. and van Vuuren, M. (2012) A Survey of Antimicrobial Usage in Animals in South Africa with Specific Reference to Food Animals. Journal of the South African Veterinary Association, 83, No. 1.

[22]   Blomberg, B., Manji, K., Urassam, W., et al. (2007) Antimicrobial Resistance Predicts Death in Tanzanian Children with Bloodstream Infections: A Prospective Cohort Study. BMC Infectious Diseases, 22, 43.

[23]   Storberg, V. (2014) ESBL-Producing Enterobacteriaceae in Africa—A Non-Systematic Literature Review of Research Published 2008-2012. Infection Ecology & Epidemiology, 4, Article ID: 20342.

[24]   Pitout, J.D. and Laupland, K.B. (2008) Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: An Emerging Public-Health Concern. The Lancet Infectious Diseases, 8, 159-166.

[25]   Murunga, E.M., Reriani, M., Otieno, C.F. and Wanyoike, N.M. (2005) Comparison of Antibiotic Use between an ‘Open’ and a ‘Closed’ Intensive Care Unit. East African Medical Journal, 82, 414-417.

[26]   Versporten, A., Bielicki, J., Drapier, N., Sharland, M., Goossens, H., et al. (2016) The Worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) Point Prevalence Survey: Developing Hospital-Quality Indicators of Antibiotic Prescribing for Children. Journal of Antimicrobial Chemotherapy, 71, 1106-1117.

[27]   Yang, Y., Xu, C., Cao, X., Lin, H. and Wang, J. (2017) Antibiotic Resistance Genes in Surface Water of Eutrophic Urban Lakes Are Related to Heavy Metals, Antibiotics, Lake Morphology and Anthropic Impact. Ecotoxicology, 26, 831-840.

[28]   Bengtsson-Palme, J. and Larsson, D.G.J. (2015) Antibiotic Resistance Genes in the Environment: Prioritizing Risks. Nature Reviews Microbiology, 13, 396.

[29]   Li, B., Yang, Y., Ma, L., Ju, F., Guo, F., Tiedje, J.M. and Zhang, T. (2015) Metagenomic and Network Analysis Reveal Wide Distribution and Co-Occurrence of Environmental Anti-Biotic Resistance Genes. The ISME Journal, 9, 2490-2502.

[30]   Martinez, J.L., Coque, T.M. and Baquero, F. (2015) What Is a Resistance Gene? Ranking Risk in Resistomes. Nature Reviews Microbiology, 13, 116-123.

[31]   Van Boeckel, T.P., Brower, C., Gilbert, M., Grenfell, B.T., Levin, S.A., Robinson, T.P., Teillant, A. and Laxminarayan, R. (2015) Global Trends in Antimicrobial Use in Food Animals. Proceedings of the National Academy of Sciences of the United States of America, 112, 5649-5654.

[32]   Bondarczuk, K., Markowicz, A. and Piotrowska-Seget, Z. (2015) The Urgent Need for Risk Assessment on the Antibiotic Resistance Spread via Sewage Sludge Land Application. Environment International, 87, 49-55.

[33]   Berendonk, T.U., Manaia, C.M., Merlin, C., et al. (2015) Tackling Antibiotic Resistance: The Environmental Framework. Nature Reviews Microbiology, 13, 310-317.

[34]   Collignon, P. (2013) Ban Routine Use of Critically Important Antibiotics in Food Animals. BMJ, 347, f4976.

[35]   So, A.D., Shah, T.A., Roach, S., et al. (2015) An Integrated Systems Approach Is Needed to Ensure the Sustainability of Antibiotic Effectiveness for Both Humans and Animals. The Journal of Law, Medicine & Ethics, 43, 38-45.

[36]   Opijah, F.J., Mukabana, J.R. and Ng’ang’a, J.K. (2007) Rainfall Distribution over Nairobi Area. Journal of Meteorological Research, 1, 3-13.

[37]   Nazir, N., Mirza, J.H., Akhtar, N., Bajwa, R. and Nasin, G. (2007) Some Studies of Thermophilic and Thermotolerant Fungi from Lahore, Pakistan. Mycopathologia, 5, 95-100.

[38]   Zaved, H.K., Rahman Mizanur, M., Rahman Mashir, M., Rahman, A., Arafat, S.M.Y. and Rahman, M.S. (2008) Isolation and Characterization of Effective Bacteria for Solid Waste Degradation for Organic Manure. KMITL Science and Technology Journal, 8, 44-55.

[39]   Cheesbrough, M. (2006) District Laboratory Practice in Tropical Countries. Part 2. Cambridge University Press, Cambridge.

[40]   Clinical and Laboratory Standards Institute (2017) Performance Standards for Antimicrobial Susceptibility Testing. 27th Edition.

[41]   Rawat, D. and Nair, D. (2010) Extended-Spectrum β-Lactamases in Gram Negative Bacteria. Journal of Global Infectious Diseases, 2, 263-274.

[42]   Jarlier, V., Nicolas, M.H., Fournier, G. and Philippon, A. (1988) Extended Broad-Spectrum Beta-Lactamases Conferring Transferable Resistance to Newer Beta-Lactam Agents in Enterobacteriaceae: Hospital Prevalence and Susceptibility Patterns. Reviews of Infectious Diseases, 10, 867-878.

[43]   Clarice, M., Anthony, S. and Shivoga, W.A. (2018) Antimicrobial Resistance Patterns of Enterobacteriaceae Recovered from Wastewater, Sludge and Dumpsite Environments in Kakamega Town, Kenya. African Journal of Microbiology Research, 12, 673-680.

[44]   Mwaikono, K.S., Maina, S. and Gwakisa, P. (2015) Prevalence and Antimicrobial Resistance Phenotype of Enteric Bacteria from a Municipal Dumpsite. Journal of Applied and Environmental Microbiology, 3, 82-94.

[45]   Odeyemi, A. (2012) Antibiogram Status of Bacterial Isolates from Air around Dumpsite of Ekiti State Destitute Centre at Ilokun, Ado-Ekiti, Nigeria. Journal of Microbiology Research, 2, 12-18.

[46]   Wachukwu, C.K., Mbata, C.A. and Nyenke, C.U. (2010) The Health Profile and impact Assessment of Waste Scavengers (Rag Pickers) in Port Harcourt, Nigeria. Journal of Applied Sciences, 10, 1968-1972.

[47]   Liu, H., Wang, Y., Wang, G., Xing, Q., Shao, L., Dong, X., Ma, L., et al. (2015) The Prevalence of Escherichia coli Strains with Extended Spectrum Beta-Lactamases Isolated in China. Frontiers in Microbiology, 6, 1-5.

[48]   Njoroge, S. (2015) Phenotypic and Genotypic Resistance Patterns among Fecal E. coli Isolated from Severely Malnourished and Non-Malnourished Children At- tending Mbagathi District Hospital, Nairobi. Master’s Thesis, Kenyatta University, Kahawa.

[49]   Tenover, F.C. (2006) Mechanisms of Antimicrobial Resistance in Bacteria. American Journal of Infection Control, 34, S3-S10.

[50]   Webber, M. and Piddock, L.J. (2001) Quinolone Resistance in Escherichia coli. Veterinary Research, 32, 275-284.

[51]   Daniel, M., Makau, P., Nyerereand, A. and Revathi, G. (2017) Antimicrobial Resistance patterns in Extended-Spectrum β-Lactamase Producing Escherichia coli and Klebsiella pneumonia Isolates in a Private Tertiary Hospital, Kenya. Microbiology Discovery, 1, 1-5.

[52]   Mehrgan, H., Rahbar, M. and Ar-ab-Halvaii, Z. (2010) High Prevalence of Extended- Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae in a Tertiary Care Hospital in Tehran, Iran. The Journal of Infection in Developing Countries, 4, 132-138.

[53]   Moyo, S.J., Aboud, S., Kasubi, M., Lyamuya, E.F. and Maselle, S.Y. (2010) Antimicrobial Resistance among Producers and Non-Producers of Extended Spectrum Beta-Lactamases in Urinary Isolates at a Tertiary Hospital in Tanzania. BMC Res Notes, 3, 348.

[54]   Kiiru, J., Kariuki, S., Goddeeris, B.M. and Butaye, P. (2012) Analysis of Beta-Lactamase Phenotypes and Carriage of Selected Beta-Lactamase Genes among Escherichia coli Strains Obtained from Kenyan Patients during an 18-Year Period. BMC Microbiology, 12, 155.

[55]   Nakane, K., Kawamura, K., Goto, K. and Arakawa, Y. (2016) Long-Term Colonization by blaCTX-M-Harboring Escherichia coli in Healthy Japanese People Engaged in Food Handling. Applied and Environmental Microbiology, 82, 1818-1827.

[56]   Zhang, H., Zhou, Y., Guo, S. and Chang, W. (2015) High Prevalence and Risk Factors of Fecal Carriage of CTX-M Type Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae from Healthy Rural Residents of Taian, China. Frontiers in Microbiology, 6, 239.

[57]   Le, Q.P., Ueda, S., Nguyen, T.N.H., Dao, T.V.K., Van Hoang, T.A., Tran, T.T.N., Vien, Q.M., et al. (2015) Characteristics of Extended-Spectrum β-Lactamase-Producing Escherichia coli in Retail Meats and Shrimp at a Local Market in Vietnam. Foodborne Pathogens and Disease, 12, 719-725.

[58]   Paltansing, S., Vlot, J.A., Kraakman, M.E., Mesman, R., Bruijning, M.L., Bernards, A.T. and Veldkamp, K.E. (2013) Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae among Travelers from the Netherlands. Emerging Infectious Diseases, 19, 1206-1213.