ArticleBMC microbiology2026
Dissemination of antibiotic-resistant enterobacteriaceae from hospital wastewater in Gabon: implications for the one health strategy.
Article in BMC microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe proliferation of Enterobacteriaceae exhibiting a multidrug-resistant phenotype in aquatic ecosystems is a major concern for global public health. In Gabon, the lack of adequate pre-treatment systems means that hospital wastewater acts as a critical reservoir associated with the spread of these pathogens into surface waters. This study aimed to characterise the bacterial load and phenotypic resistance profiles of Enterobacteriaceae isolated from the effluents of eleven Gabonese hospitals, whilst assessing the environmental factors associated with their presence. METHODOLOGY: Between 2023 and 2024, 98 samples were collected (52 from hospital effluents and 46 from environmental waters). Physico-chemical parameters (pH, temperature) and visual indicators (color, debris, foam) were recorded. Following serial dilutions and cultivation on selective agar media, 113 Enterobacteriaceae isolates were identified using API 20E and VITEK
resultsThe bacterial load was significantly higher in hospital wastewater (up to 1.68 × 10⁸ CFU/mL) than in surface water. Univariate analysis revealed that the presence of debris (p = 0.003), foam (p = 0.016) and a greyish or brownish colouration of the water (p = 0.028) were visual indicators significantly markers of environmental pollution rather than confirmed causal factors. All confirmed Enterobacteriaceae isolates (n = 113) exhibited a multidrug-resistant phenotype, with rates of resistance to beta-lactams exceeding 95%. The genus Escherichia (n = 45) was predominant.
conclusionThis observational study demonstrates that untreated hospital wastewater in Gabon is a significant source of microbiological pollution. Environmental visual indicators are useful for identifying areas with high bacterial loads. It is necessary to develop pre-treatment infrastructure to mitigate the associated environmental and health risks.
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