Phenotypic Antibiotic Resistance Patterns of Escherichia coli Isolates from Clinical UTI Samples and Municipal Wastewater in a Grenadian Community

Makeda Matthew-Bernard, Karla Farmer-Diaz, Grace Dolphin-Bond, Vanessa Matthew-Belmar, Sonia Cheetham, Kerry Mitchell, Calum N. L. Macpherson and Maria E. Ramos-Nino ()
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Makeda Matthew-Bernard: Department of Microbiology, Immunology, and Pharmacology, School of Medicine, St. George’s University, St. George’s P.O. Box 7, Grenada
Karla Farmer-Diaz: Department of Microbiology, Immunology, and Pharmacology, School of Medicine, St. George’s University, St. George’s P.O. Box 7, Grenada
Grace Dolphin-Bond: Department of Microbiology, Immunology, and Pharmacology, School of Medicine, St. George’s University, St. George’s P.O. Box 7, Grenada
Vanessa Matthew-Belmar: Department of Pathobiology, School of Veterinary Medicine, St. George’s University, St. George’s P.O. Box 7, Grenada
Sonia Cheetham: Department of Pathobiology, School of Veterinary Medicine, St. George’s University, St. George’s P.O. Box 7, Grenada
Kerry Mitchell: Department of Public Health and Preventive Medicine, School of Medicine, St. George’s University, St. George’s P.O. Box 7, Grenada
Calum N. L. Macpherson: School of Graduate Studies, St. George’s University, St. George’s P.O. Box 7, Grenada
Maria E. Ramos-Nino: Department of Microbiology, Immunology, and Pharmacology, School of Medicine, St. George’s University, St. George’s P.O. Box 7, Grenada

IJERPH, 2025, vol. 22, issue 1, 1-17

Abstract: Antimicrobial resistance (AMR) is a growing global health threat. This study investigated antibiotic resistance in E. coli isolates from municipal wastewater (86 isolates) and clinical urinary tract infection (UTI) cases (34 isolates) in a Grenadian community, using data from January 2022 to October 2023. Antibiogram data, assessed per WHO guidelines for Critically Important antimicrobials (CIA), showed the highest resistance levels in both clinical and wastewater samples for ampicillin, followed by amoxicillin/clavulanic acid and nalidixic acid, all classified as Critically Important. Similar resistance was observed for sulfamethoxazole-trimethoprim (highly important) in both groups, with nitrofurantoin showing resistance in the important category. According to the WHO AWaRe classification, ampicillin (ACCESS group) had the highest resistance, while nitrofurantoin had the lowest across all samples. The WATCH group antibiotics, cefuroxime and cefoxitin, showed comparable resistance levels, whereas aztreonam from the RESERVE group (tested only in wastewater) was 100% sensitive. Multiple Antibiotic Resistance (MAR) index analysis revealed that 7% of wastewater and 38.2% of clinical samples had MAR values over 0.2, indicating prior antibiotic exposure in clinical isolates. These parallel patterns in wastewater and clinical samples highlight wastewater monitoring as a valuable tool for AMR surveillance, supporting antibiotic stewardship through ongoing environmental and clinical assessment.

Keywords: antibiotic resistance; phenotypic analysis; clinical isolates; wastewater surveillance; Escherichia coli; Grenada (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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