A one health approach to investigating the occurrence and Antimicrobial susceptibility patterns of escherichia coli in Infants, animals, and the household environment in Bishoftu, ethiopia
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Date
2025
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Addis Abeba University
Abstract
Pathogenic and antimicrobial-resistant E. coli remains a serious public health threat, particularly in household settings where humans and animals share space and access to clean water, hygiene, and sanitation facilities is limited. Data on the occurrence of pathogenic and antimicrobial-resistant (AMR) E. coli in infants, animals, and the environment within household settings in Bishoftu town is currently lacking. The objective of this study was to assess the occurrence and antimicrobial resistant profiles of E. coli and hygienic practices at One Health domain in infants, animals, and the environment in household setting in Bishoftu, Ethiopia. A cross-sectional study was conducted from February 2, 2024 to April 26, 2025. Household-level data on access to clean water, sanitation, and hygiene practices were collected through face-to-face interviews with infant caregivers. For microbiological analysis, four samples-one each from infants, soil, caregivers, and animals-were collected per household, totaling 288 samples from 72 households. Isolation and identification of E. coli were performed using standard techniques, including primary and secondary selective enrichment, selective plating, and molecular methods. Confirmation of E. coli was done using
Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) mass spectrometry, and conventional PCR was used to detect the intimin (eae) gene in positive isolates. Antimicrobial susceptibility of the isolates was assessed using the Kirby-Bauer disk diffusion method. Among the surveyed households, 61.1% did not treat their water, 63.9% used shared latrines, 81.9% lacked handwashing facilities near latrines, and 43.1% left animal feces unmanaged within the compound. Of the 288 samples tested, 268 (69 from infants, 66 from soil, 63 from caregivers, and 70 from animals) yielded positive cultures. From these, 152 presumptive E. coli isolates were identified, with 66 confirmed using MALDI-TOF. Based on the distribution of positive isolates per household, 33 samples were selected for further analysis using PCR and antimicrobial susceptibility testing. According to MALDI-TOF results, the highest detection rate of E. coli was
found in animals (51.3%), followed by soil (40.5%), caregivers (44.4%), and infants (37.5%). Of the 33 isolates tested, only 7 (4 from infants, 1 from caregivers, and 2 from animals) were positive for the eae gene. A significant proportion of these isolates showed antimicrobial resistance, with the highest resistance observed in animals (55.6%), followed by infants (52.8%), caregivers (51.4%), and soil (37.5%). The highest resistance was recorded against amoxicillin (100%), tetracycline (78.8%), and amoxicillin-clavulanic acid (72.7%). All isolates were susceptible to gentamicin. Multidrug resistance was detected in 42.4% of the isolates. In conclusion, the study demonstrates the occurrence and distribution of pathogenic and antimicrobial-resistant E. coli across the One Health domains. It also reveals critical sanitation gaps, including reliance on shared facilities and inadequate access to basic hygiene infrastructure, such as soap and water near latrines. These findings highlight the urgent need for integrated interventions to improve access to clean water, sanitation, hygiene, and animal management, using a One Health approach.
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Keywords
E. coli, antimicrobial resistance, One health, Infants, Soil, animals, Bishoftu.