PROFILES OF EXTENDED SPECTRUM BETA-LACTAMASE AND CARBAPENEMASE GENES IN Escherichia coli ISOLATED FROM WATER SOURCES AND WILD BABOONS IN RIAT HILLS, WESTERN KENYA

Antimicrobial resistance is a growing problem in modern healthcare worldwide. The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) poses a serious threat to the health and medical safety of patients mostly children who are the most vulnerable group. Presence of E. coli in livestock that are closely in contact with humans plus their interactions with the wild animal populations including NHPs through shared habitats increases the risk of spreading AMR to a vast range of susceptible hosts even when wildlife has not been exposed to antimicrobial pressure. Riat Hills is home to a diverse range of wildlife such as baboons. It also neighbors Obunga slums, which is estimated to have 43% antibiotic use, with suspected increase of ESBLs genes, blaTEM, blaSHV, blaCTX-M and carbapemen are blaNDM, blaKPC and blaOXA. These genes are present on transferable plasmids and are flanked by transposable elements. Their co-existence increases the AMR burdens. This study determined the prevalence of ESBLs and carbapenem genes in different strains of E. coli. It specifically determined the association between the phenotypic and genetic profiles of drug resistance in different E. coli strains, and resistant patterns of different pathotypes of carbapenem resistant E. coli (CREco) isolated from water sources and stools of wild baboons in Riat Hills, Kisumu County, Kenya. The study used a cross-sectional design. A total 222 fecal and water samples were collected. Freshly voided faeces were colleted using sterile cotton tipped applicator swab moistened in normal saline, with care to collect from the top of the sample to avoid ground contamination. Water samples were randomly sampled from locations that were representative of the entire water sources then collected in amber-colored sterile bottles. Bacterial isolation and identification from stool and water samples were processed and assayed using standard microbiological techniques to isolate E.coli. Data obtained from microbiological assay, antimicrobial susceptibility testing, and molecular detection of resistance genes were coded and entered into Microsoft Excel and exported to R statistical software (version 4.3.0) and SPSS (version 27) for analysis. There was strong association between resistance genes and sample source. blaSHV (OR = 6.48, 95% CI: 1.64–25.6) and OXA-23 (OR = 28.6, 95% CI: 3.2–255.1) were significantly associated with fecal isolates, while blaCTX-M showed no significant association. There was no association between phenotypic – genotypic resistance (kappa 0.01 - 0.20, p-value> 0.05). Sulfamethoxazole showed widespread resistance across pathotypes while Ciprofloxacin suggested differential susceptibility. ETEC and EAEC clustered together indicating similar antimicrobial resistance patterns. EPEC pathotype showed high (41%) predicted probability and strong association with MDR (OR = 3.21, p = 0.03). In conclusion, given the rise of antibiotic resistance and the high prevalence of ESBL and carbapenem production in E.coli, plus the importance of this issue in the field of treatment and public health, and the costs associated with it, precise infection control and careful monitoring of antibiotic administration is crucial. Thus, routine screening of ESBL-producing isolates before prescribing antibiotics is recommended to prevent prolonged and inappropriate use of antibiotics and therapeutic failures.