The Assessment of Antibiotic Resistant Bacteria in Pharmaceutical Effluents from Major Pharmaceutical Companies in Accra, Ghana

Abstract

Antibiotic resistance is a threat to global health. The study isolated clinically relevant Enterobacteriaceae bacteria strains from  pharmaceutical effluent samples coded as EC, KP and EPRC facilities (company names not to be disclosed) and assessed their antibiotic  resistance profile. The study compared the sensitivity of MALDI-TOF MS and API 20E in identification of bacteria isolated and evaluated  the presence of β-lactam resistance. The methods used are the pour plate, bacteria isolation, gram-staining, identification by MALDI-TOF  MS and API 20E, antibiotic susceptibility testing, and Extended Spectrum β-Lactamase. The results of the total viable count and total  coliform count (cfu/ml) of pharmaceutical effluent samples were >106 . The Enterobacteriaceae isolates tested for antibiotic sensitivity  showed 50%, 66.67%, 100%, 66.67%, 83.33%, 83.33%, 91.66%, 66.67%, 75% and 58.33% resistance to Cefepime, Cefoxitin, Ciprofloxacin,  Cefotaxime, Cefuroxime, Tetracycline, Sulfamethoxazole, Norfloxacin, Ampicillin and Chloramphenicol, respectively. Ceftazidime,  Gentamycin, Amikacin and Meropenem were sensitive up to 75%, 66.67%, 75% and 50% of bacteria isolates, respectively. Multiple  antibiotic resistance from 3 up to 12 antibiotics occurred in 100% of isolates. E. cloacae isolates were resistant to 9-11 out of a total of 14  antibiotics tested and sensitive to only 2-5 of the antibiotics. Klebsiella spp. isolate was resistant to 4 antibiotics and sensitive to 9  antibiotics. C. freundii was resistant to 12 (85.71%) and sensitive to 2 antibiotics. K. pneumoniae strains were resistant to 9-10 antibiotics  and sensitive to 3 antibiotics. A. hydrophila and A. caviae isolates were resistant to 12 antibiotics and sensitive to 2 antibiotics. P. otitidis  isolate was resistant to 5 antibiotics and sensitive to 6 antibiotics. The results of the study reveal that pharmaceutical industrial effluents  are flashpoints for antibiotic resistant bacteria. To reduce or prevent pharmaceutical industrial activity effect on antibiotic resistance in  the environment, a multi-part one-health approach, multi-sectorial commitment, and national action plan are recommended.