Phenotypic Characterization and Antibiograms of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolated at the Human-Animal-Environment Interface Using a One Health Approach Among Households in Wakiso District, Uganda

James Muleme,1,2 Clovice Kankya,2 Musso Munyeme,3 David Musoke,1 John C Ssempebwa,1 John Bosco Isunju,1 Rogers Wambi,2,4 Bonny Enock Balugaba,1 Tahalu Sekulima,5 Richard K Mugambe,1 Simeon Cadmus,6 Henry M Kajumbula7 1Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda; 2Department of Biosecurity Ecosystems and Veterinary Public Health, Makerere University College of Veterinary Medicine Animal Resources and Biosecurity, Kampala, Uganda; 3Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia; 4Department of Clinical Laboratory, Mulago National Referral Hospital, Kampala, Uganda; 5Department of Biotechnical and Diagnostic Sciences, Veterinary Microbiology Research Laboratory, College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda; 6Department of Veterinary Public Health and Preventive Medicine, Center for Control and Prevention of Zoonoses, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria; 7Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, UgandaCorrespondence: James Muleme, Email mulemej@gmail.comBackground: The occurrence of extended spectrum beta-lactamase (ESBL) producing bacteria such as Escherichia coli has increasingly become recognized beyond hospital settings. Resistance to other types of antibiotics limits treatment options while the existence of such bacteria among humans, animals, and the environment is suggestive of potential zoonotic and reverse-zoonotic transmission. This study aimed to establish the antibiotic susceptibility profiles of the ESBL-producing Escherichia coli (ESBL-EC) from human, animal, and environmental isolates obtained among farming households within Wakiso district using a One Health approach.Methods: A total of 100 ESBL-EC isolates from humans 35/100 (35%), animals 56/100 (56%), and the environment 9/100 (9%) were tested for susceptibility to 11 antibiotics. This was done using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed in STATA ver. 16 and graphs were drawn in Microsoft excel ver. 10.Results: Most of the ESBL-EC isolates (98%) were resistant to more than two antibiotics. ESBL-EC isolates were most susceptible to meropenem (MEM) (88.0%), and imipenem (82.0%) followed by gentamicin (72%). ESBL-EC isolates from humans were most susceptible to meropenem (MEM) followed by imipenem (IPM)> gentamicin (CN)> ciprofloxacin (CIP). Animal samples were more susceptible to MEM, IPM, and CN but were highly resistant to cefotaxime (CTX)> cefepime (FEP)>other antibiotics. Multidrug resistance (MDR) was mostly reported among households keeping goats under intensive husbandry practices. Seven percent of the isolates exhibited carbapenem resistance while 22% showed aminoglycoside resistance. Similar resistance patterns among humans, animals, and environmental samples were also reported.Conclusion: Our study provides baseline information on non-hospital-based MDR caused by ESBL-EC using a One Health approach. ESBL-EC isolates were prevalent among apparently healthy community members, animals, and their environment. It is important to conduct more One Health approach studies to generate evidence on the drivers, resistance patterns, and transmission of ESBL-producing organisms at the human-animal-environmental interface.Keywords: antibiogram, community, ESBL-producing, Escherichia coli, one health, Wakiso