ArticleThe Science of the total environment2024
Key environmental exposure pathways to antimicrobial resistant bacteria in southern Malawi: A SaniPath approach.
Article in The Science of the total environment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Genomic epidemiology of extended-spectrum beta-lactamase-producingJAC-antimicrobial resistance · 2026Article
- Evaluation of detection performance and cost-effectiveness of IDEXX Colilert-18 and ChromAgar for environmental surveillance of extended-spectrum beta-lactamaseMicrobiology spectrum · 2026Article
- Animal husbandry and environmental conditions are associated with cefotaxime-resistantmedRxiv : the preprint server for health sciences · 2026Article
- Animal husbandry and environmental conditions are associated with cefotaxime-resistant Escherichia coli in yard soil in peri-urban Malawi.PLOS global public health · 2026Article
- Antimicrobial susceptibility of Escherichia coli, Klebsiella pneumoniae, and Enterococcus species and the associated risk factors in poultry farms in Blantyre City: a wake-up call to the one health approach.BMC veterinary research · 2025Article
- No evidence of multidrug-resistantMicrobiology spectrum · 2025Observational
- Environmental hazards from pollution of antibiotics and resistance-driving chemicals in an urban river network from Malawi.npj antimicrobials and resistance · 2025Article
- Prevalence of Antibiotic Resistance Bacteria in Manure, Soil, and Vegetables in Urban Blantyre, Malawi, from a Farm-to-Fork Perspective.International journal of environmental research and public health · 2025Article
- Quantitative multi-pathway assessment of exposure to Escherichia coli for infants in Rural Ethiopia.PLoS neglected tropical diseases · 2025Article
- Risk Perception and Psychosocial Factors Influencing Exposure to Antimicrobial Resistance through Environmental Pathways in Malawi.The American journal of tropical medicine and hygiene · 2025Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Antimicrobial resistance (AMR) poses a severe global health threat, yet the transmission pathways of AMR within communal public environments, where humans and animals interact, remain poorly explored. This study investigated AMR risk pathways, prevalence, and seasonality of extended-spectrum β-lactamase (ESBL) producing E. coli and K. pneumoniae, and observed practices contributing to environmental contamination within urban, peri-urban, and rural Malawi. Using the SaniPath tool, in August 2020, transect walks across three Malawian study sites identified potential AMR exposure pathways, including drains, standing water, soil, and areas of communal hand contact. Subsequently, from September-2020 to August-2021, 1440 environmental samples were collected at critical points along exposure routes (n = 40/month from each site). These underwent microbiological analysis using chromogenic agar techniques to detect the presence of ESBL E. coli and ESBL K. pneumoniae. Results showed the highest ESBL prevalence in urban environments (68.1 %, 95%CI = 0.64-0.72, p < 0.001) with a higher ESBL presence seen in drains (58.8 %, 95%CI = 055-0.62, p < 0.001) and soil (54.1 %, 95%CI = 0.46-0.62, p < 0.001) compared to other pathways. Environmental contamination was attributed to unavailability and poor condition of sanitation and hygiene infrastructure based on key informant interviews with community leaders (n = 9) and confirmed by independent observation. ESBL prevalence varied between seasons (χ
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