The Role of Drinking Water as a Source of Transmission of Antimicrobial Resistant Escherichia coli

• Main Author: Coleman, Brenda Lee
• Other Authors: McGeer, Allison
• Format: Others
• Language: en_ca
• Published: 2008
• Subjects: epidemiology; public health science; 0766
• Online Access: http://hdl.handle.net/1807/17297

Antimicrobial resistance is a serious threat to the treatment of infectious diseases and a leading public health concern of the 21st century. Antimicrobial resistant E. coli has been detected in many places including domestic livestock, humans, food items, surface water, and drinking water. Although the use of antibiotics is a major contributor to the emergence of resistance, the ingestion of water contaminated with antimicrobial resistant bacteria may contribute to the prevalence of antimicrobial resistance in humans. Purpose: The objectives of the research were to determine the prevalence of human faecal carriage of antimicrobial resistant E. coli in people residing in southern Ontario who used private water sources and to determine whether the use of water contaminated with antimicrobial resistant E. coli was associated with human carriage of same. Method: The study population consisted of people living in Ontario households that submitted water samples from private water sources for bacteriological testing between May 2005 and September 2006. Respondents completed a questionnaire and submitted a self-collected rectal swab. Results: Antimicrobial resistant E. coli were detected in the swabs of 41% of the 699 respondents, with 28% resistant to ampicillin, 25% to tetracycline, and 24% to sulfisoxazole, and 29% that were multi-drug resistant. Subjects from households using untreated water contaminated with antimicrobial resistant E. coli were 40% more likely to carry antimicrobial resistant E. coli in their gastrointestinal system than people from households using uncontaminated water, even after adjusting for the effect of other variables. Implications: The association between the consumption of water contaminated with antimicrobial resistant E. coli and human carriage of resistant E. coli highlights the ongoing risks associated with water contamination and antimicrobial resistance in Ontario. The high rates of resistant E. coli in healthy non-institutional persons provides further rationale for public health programs to reduce antibiotic use in medicine and agriculture.