Extended-Spectrum Beta-Lactamase-Producing in Drinking Water Samples From a Forcibly Displaced, Densely Populated Community Setting in Bangladesh

Community-acquired infections due to extended-spectrum beta-lactamase (ESBL) producing are rising worldwide, resulting in increased morbidity, mortality, and healthcare costs, especially where poor sanitation and inadequate hygienic practices are very common. This study was conducted to investigate the prevalence and characterization of multidrug-resistant (MDR) and ESBL-producing in drinking water samples collected from Rohingya camps, Bangladesh. A total of 384 isolates were analyzed in this study, of which 203 were from household or point-of-use (POU) water samples, and 181 were from source water samples. The isolates were tested for virulence genes, ESBL-producing genes, antimicrobial susceptibility by VITEK 2 assay, plasmid profiling, and conjugal transfer of AMR genes. Of the 384 isolates tested, 17% (66/384) were found to be ESBL producers. The abundance of ESBL-producers in source water contaminated with was observed to be 14% (27/181), whereas, 19% (39/203) ESBL producers was found in household POU water samples contaminated with . We detected 71% (47/66) ESBL to be MDR. Among these 47 MDR isolates, 20 were resistant to three classes, and 27 were resistant to four different classes of antibiotics. Sixty-four percent (42/66) of the ESBL producing carried 1 to 7 plasmids ranging from 1 to 103 MDa. Only large plasmids with antibiotic resistance properties were found transferrable via conjugation. Moreover, around 7% (29/384) of isolates harbored at least one of 10 virulence factors belonging to different pathotypes. The findings of this study suggest that the drinking water samples analyzed herein could serve as an important source for exposure and dissemination of MDR, ESBL-producing and pathogenic lineages, which therewith pose a health risk to the displaced Rohingya people residing in the densely populated camps of Bangladesh.