{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:20:19Z","timestamp":1789849219131,"version":"4.0.1"},"reference-count":64,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T00:00:00Z","timestamp":1624147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Infections by Extended-Spectrum Beta-Lactamase producing Escherichia coli (ESBL-Ec) are on the increase in Ghana, but the level of environmental contamination with this organism, which may contribute to growing Antimicrobial Resistance (AMR), is unknown. Using the WHO OneHealth Tricycle Protocol, we investigated the contamination of E. coli (Ec) and ESBL-Ec in two rivers in Ghana (Odaw in Accra and Okurudu in Kasoa) that receive effluents from human and animal wastewater hotspots over a 12-month period. Concentrations of Ec, ESBL-Ec and percent ESBL-Ec\/Ec were determined per 100 mL sample. Of 96 samples, 94 (98%) were positive for ESBL-Ec. concentrations per 100 mL (MCs100) of ESBL-Ec and %ESBL-Ec from both rivers were 4.2 \u00d7 104 (IQR, 3.1 \u00d7 103\u20132.3 \u00d7 105) and 2.79 (IQR, 0.96\u20136.03), respectively. MCs100 were significantly lower in upstream waters: 1.8 \u00d7 104 (IQR, 9.0 \u00d7 103\u20133.9 \u00d7 104) as compared to downstream waters: 1.9 \u00d7 106 (IQR, 3.7 \u00d7 105\u20135.4 \u00d7 106). Both human and animal wastewater effluents contributed to the increased contamination downstream. This study revealed high levels of ESBL-Ec in rivers flowing through two cities in Ghana. There is a need to manage the sources of contamination as they may contribute to the acquisition and spread of ESBL-Ec in humans and animals, thereby contributing to AMR.<\/jats:p>","DOI":"10.3390\/tropicalmed6020105","type":"journal-article","created":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T21:50:15Z","timestamp":1624225815000},"page":"105","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Extended Spectrum Beta-Lactamase Escherichia coli in River Waters Collected from Two Cities in Ghana, 2018\u20132020"],"prefix":"10.3390","volume":"6","author":[{"given":"Regina","family":"Banu","sequence":"first","affiliation":[{"name":"CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Department of Surveillance Prevention and Control of AMR, AMR Division, World Health Organization, Route de Sauverny 22, 1290 Versoix, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Reid","sequence":"additional","affiliation":[{"name":"Operational Research Unit (LuxOR), Medical Department, M\u00e9decins Sans Fronti\u00e8res Operational Centre Brussels, L-1617 Luxembourg, Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0692-850X","authenticated-orcid":false,"given":"Wendemagegn","family":"Enbiale","sequence":"additional","affiliation":[{"name":"Dermatovenereology Department, Bahir Dar University, BahirDar P.O. Box 1996, Ethiopia"},{"name":"Amsterdam UMC, Academic Medical Centre, Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&I), University of Amsterdam, 1012 WX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Appiah-Korang","family":"Labi","sequence":"additional","affiliation":[{"name":"WHO Country Office, Ghana, 7 Ameda Street, Roman Ridge, Accra P.O. Box MB 142, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebenezer","family":"Ansa","sequence":"additional","affiliation":[{"name":"Council for Scientific and Industrial Research-Animal Research Institute, Adenta-Frafraha, Achimota-Accra P.O. Box AH 20, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Annan","sequence":"additional","affiliation":[{"name":"World Health Organization, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Akrong","sequence":"additional","affiliation":[{"name":"CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selorm","family":"Borbor","sequence":"additional","affiliation":[{"name":"CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9478-0057","authenticated-orcid":false,"given":"Lady","family":"Adomako","sequence":"additional","affiliation":[{"name":"CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4790-152X","authenticated-orcid":false,"given":"Hawa","family":"Ahmed","sequence":"additional","affiliation":[{"name":"CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Mustapha","sequence":"additional","affiliation":[{"name":"CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9836-4261","authenticated-orcid":false,"given":"Hayk","family":"Davtyan","sequence":"additional","affiliation":[{"name":"Tuberculosis Research and Prevention Center NGO, Yerevan 0040, Armenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Owiti","sequence":"additional","affiliation":[{"name":"The International Union against Tuberculosis and Lung Disease, 68 Boulevard Saint Michel, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Hedidor","sequence":"additional","affiliation":[{"name":"WHO Country Office, Ghana, 7 Ameda Street, Roman Ridge, Accra P.O. Box MB 142, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3743-020X","authenticated-orcid":false,"given":"Gerard","family":"Quarcoo","sequence":"additional","affiliation":[{"name":"CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Opare","sequence":"additional","affiliation":[{"name":"National Public Health & Reference Laboratory Ghana Health Service, Accra P.O. Box 300, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boi","family":"Kikimoto","sequence":"additional","affiliation":[{"name":"National Food Safety\/AMR Reference Laboratory for Animal Health (Terrestrial & Aquatic Animals), Veterinary Services, Accra P.O. Box M 161, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8541-5015","authenticated-orcid":false,"given":"Mike","family":"Osei-Atweneboana","sequence":"additional","affiliation":[{"name":"CSIR-Water Research Institute, Council for Scientific and Industrial Research, 2nd CSIR Close, Achimota, Accra P.O. Box AH 38, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Centre for Zoonoses and Environmental Microbiology, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands"},{"name":"WHO Collaborating Centre for Risk Assessment of Pathogens in Food and Water at the National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,20]]},"reference":[{"key":"ref_1","unstructured":"WHO (2017). Global Action Plan on Antimicrobial Resistance, World Health Organization. Available online: https:\/\/www.paho.org\/en\/documents\/global-action-plan-antimicrobial-resistance-2017."},{"key":"ref_2","unstructured":"World Organization for Animal Health (2021, June 20). The OIE Strategy on Antimicrobial Resistance and the Prudent Use of Antimicrobials. Available online: https:\/\/www.oie.int\/app\/uploads\/2021\/03\/en-oie-amrstrategy.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Founou, R.C., Founou, L.L., and Essack, S.Y. (2017). Clinical and economic impact of antibiotic resistance in developing countries: A systematic review and meta-analysis. 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