Assessing the impact of recreational water use on carriage of antimicrobial resistant organisms

Maeve Louise Farrell; Alexandra Chueiri; Louise O'Connor; Sinead Duane; Mark Maguire; Georgios Miliotis; Martin Cormican; Brigid Hooban; Anne Leonard; William H Gaze; Genevieve Devane; Alma Tuohy; Liam P Burke; Dearbháile Morris

doi:10.1016/j.scitotenv.2023.164201

Assessing the impact of recreational water use on carriage of antimicrobial resistant organisms

Sci Total Environ. 2023 Aug 25:888:164201. doi: 10.1016/j.scitotenv.2023.164201. Epub 2023 May 15.

Affiliations

¹ Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Ireland. Electronic address: [email protected].
² Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Ireland.
³ Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Ireland; J.E. Cairnes School of Business and Economics, University of Galway, Ireland.
⁴ Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Ireland; National Carbapenemase-producing Enterobacterales Reference Laboratory Service, Ireland.
⁵ European Centre for Environment and Human Health, University of Exeter Medical School, Cornwall, UK.
⁶ National Carbapenemase-producing Enterobacterales Reference Laboratory Service, Ireland.

PMID: 37196970
DOI: 10.1016/j.scitotenv.2023.164201

Abstract

Understanding the role of exposure to natural recreational waters in the acquisition and transmission of antimicrobial resistance (AMR) is an area of increasing interest. A point prevalence study was carried out in the island of Ireland to determine the prevalence of colonisation with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) and carbapenem-resistant Enterobacterales (CRE) in recreational water users (WU) and matched controls. A total of 411 adult participants (199 WU, 212 controls) submitted at least one faecal sample between September 2020 - October 2021. In total, 80 Enterobacterales were isolated from 73 participants. ESBL-PE were detected in 29 (7.1 %) participants (7 WU, 22 controls), and CRE were detected in nine (2.2 %) participants (4 WU, 5 controls). No carbapenemase-producing Enterobacterales (CPE) were detected. WU were significantly less likely to harbour ESBL-PE than controls (risk ratio = 0.34, 95 % CI 0.148 to 0.776, χ² 7.37, p = 0.007). This study demonstrates the occurrence of ESBL-PE and CRE in healthy participants in Ireland. Recreational exposure to bathing water in Ireland was associated with a decreased prevalence of colonisation with ESBL-PE and CRE.

Keywords: Antimicrobial resistance; Carbapenem resistance; Extended spectrum beta-lactamase; Public health; Recreational water.

MeSH terms

Adult
Anti-Bacterial Agents
Anti-Infective Agents*
Carbapenems
Enterobacteriaceae Infections* / epidemiology
Feces
Gammaproteobacteria*
Humans
Water
beta-Lactamases

Substances

Water
beta-Lactamases
Carbapenems
Anti-Infective Agents
Anti-Bacterial Agents