Journal of Environment Pollution and Human Health
ISSN (Print): 2334-3397 ISSN (Online): 2334-3494 Website: https://www.sciepub.com/journal/jephh Editor-in-chief: Dibyendu Banerjee
Open Access
Journal Browser
Go
Journal of Environment Pollution and Human Health. 2024, 12(2), 10-23
DOI: 10.12691/jephh-12-2-1
Open AccessArticle

Vulnerability of Groundwater to Hospital Wastewater Driving Antimicrobial-resistant Pseudomonas aeruginosa, in Cameroon Central Africa

Eheth Jean Samuel1, , Moussa Djaouda2, Tamatcho Kweyang Blandine Pulchérie1, Noah Ewoti Olive Vivien3, Fotsing Kwetche Pierre Réné4, Tamsa Arfao Antoine3, Moungang Luciane Marlyse3 and Nola Moïse3

1Départment of Microbiology, University of Yaounde I, Cameroon

2Higher Teachers’ Training College, University of Maroua, Cameroon

3Department of Animal Biology and Physiology, University of Yaounde I, Cameroon

4Department of Microbiology, Université des Montagnes, Bagangte, Cameroon

Pub. Date: July 01, 2024

Cite this paper:
Eheth Jean Samuel, Moussa Djaouda, Tamatcho Kweyang Blandine Pulchérie, Noah Ewoti Olive Vivien, Fotsing Kwetche Pierre Réné, Tamsa Arfao Antoine, Moungang Luciane Marlyse and Nola Moïse. Vulnerability of Groundwater to Hospital Wastewater Driving Antimicrobial-resistant Pseudomonas aeruginosa, in Cameroon Central Africa. Journal of Environment Pollution and Human Health. 2024; 12(2):10-23. doi: 10.12691/jephh-12-2-1

Abstract

In Cameroon, the dissemination of antibiotic-resistant bacteria in groundwater via hospital wastewater has not been sufficiently explored, despite the growing volume of lesstreated wastewater generated. This study aimed at assessing the impact of hospital wastewaters on the prevalence of antimicrobial-resistant P. aeruginosa in the groundwater, in two urban areas, Douala and Yaounde (Cameroon, Central Africa). In each urban area, 12 wells water and 2 hospitals effluents were sampled for water analysis. The wells water were then divided into two groups. Those close to hospitals (WCH) and those far from hospitals (WFH). The level of resistance among P. aeruginosa strains was assessed against 16 antimicrobial agents belonging to the β-Lactam, Aminoglycosid, Quinolone, and Polymyxin groups. P. aeruginosa resistance rate was significantly higher in WCH than WFH (p<0.05). This result was observed in Douala with seven antibiotics: ticarcillin/clavulanic acid (31.3% vs 9.86%), ticarcillin (47.3% vs 4.93%), piperacillin (35.9% vs 4.32%), ceftazidime (44.3% vs 7.04%), gentamicin (37.4% vs 9.15%), ofloxacin (24.4% vs 4.22%), and ciprofloxacin (14.5% vs 0%); and in Yaounde with six drugs: ticarcillin/clavulanic acid, ticarcillin, piperacillin, cefepime, gentamicin, and ofloxacin, (30% vs 8.63%; 44.4% vs 8.63%; 21.8% vs 10.79%; 39.1% vs 7.91%; 21.1% vs 2.88%; 56.4% vs 15.11%, respectively). The WCH are vulnerable to the hospital effluents.

Keywords:
Groundwater vulnerability hospital wastewater antimicrobial-resistance P. aeruginosa

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Akoachere, J., Kihla, T., Omam, L., Massalla, T.N., "Assessment of the relationship between bacteriological quality of dug-wells, hygiene behaviour and well characteristics in two cholera endemic localities in Douala, Cameroon". BMC Public Health, 13, 692, Jul. 2013.
 
[2]  Eheth, J.S., Djimeli, C.L., Nana, P.A., Tamsa Arfao, A., Noah Ewoti, O.V., Moungang, L.M., Bricheux, G., Sime‑Ngando, T., Nola, M., "Less efect of wells physicochemical properties on the antimicrobial susceptibility Pseudomonas aeruginosa isolated in equatorial region of Central Africa". Applied Water Science, 9, 30, Feb. 2019.
 
[3]  Njoya, A.M., Poutoum, Y.Y., Eheth, J.S., Tamnou Mouafo, E.B., Metsopkeng, C.S., Noah Ewoti, O.V., Tamsa Arfao, A., Moungang, L.M., Nana, P.A., Chinche Belengfe, S., Masseret, E., Sime-Ngando, T., Nola, M., "Antibiotic susceptibility of four Enterobacteriaceae strains (Enterobacter cloacae, Citrobacter freundii, Salmonella typhi and Shigella sonnei) isolated from wastewater, surface water and groundwater in the equatorial zone of Cameroon (Central Africa)". World J. Adv. Res. Rev., 11 (1), 120–137, Jul. 2021.
 
[4]  Nola, M., Njine, T., Sikati, V.F., Djuikom, E., "Distribution of Pseudomonas aeruginosa and Aeromonas hydrophila in grounwaters in equatorial region of Cameroon and relationships with some chemical parameters of water". Rev. Sci. Eau, 14 (01), 35–53, Jan. 2001.
 
[5]  Nougang, M.E., Nola, M., Djuikom, E., Noah Ewoti, O.V., Moungang, L.M., Ateba, B.H., "Abundance of faecal coliforms and pathogenic E. coli strains in groundwater in the coastal zone of Cameroon (Central Africa), and relationships with some abiotic parameters". Cur. Res. J. Biol. Sc., 3(6), 622–632, Nov. 2011.
 
[6]  Kümmerer, K., "Antibiotics in the aquatic environment – a review – part II". Chemosphere, 75(4), 435–441, Apr. 2009.
 
[7]  Wood, L.F., Ohman, D.E., "Use of cell wall stress to characterize -22(AlgT/U) activation by regulated proteolysis and its regulon in Pseudomonas aeruginosa". Mol. Microbiol., 72(1), 183–201, March 2009.
 
[8]  Poole, K., "Bacterial stress responses as determinants of antimicrobial resistance". J. Antimicrob. Chemother., 67(9), 2069–2089, Sept. 2012a.
 
[9]  Macdonald, I.A., Kuehn, M.J., "Stress-induced outer membrane vesicle production by Pseudomonas aeruginosa". J. Bacteriol., 195(13), 2971–2981, Jul. 2013.
 
[10]  Njall, C., Adiogo, D., Bita, A., Ateba, N., Sume, G., Kollo, B., Binam, F., Tchoua, R., "Bacterial ecology of nosocomial infection in the intensive care unit of Laquintinie hospital in Douala, Cameroon". Pan. Afr. Med. J., 14, 140, Apr. 2013.
 
[11]  Madaha, E.L., Gonsu, K.H., Bughe, R.N., Fonkoua, M.C., Ateba, C.N., Mbacham, W.F., "Occurrence of blaTEM and blaCTXM Genes and Biofilm-Forming Ability among Clinical Isolates of Pseudomonas aeruginosa and Acinetobacter baumannii in Yaoundé, Cameroon". Microorganisms, 8(5), 708, May 2020.
 
[12]  Djuikoue, C.I., Djouela Djoulako, P.D., Same Njanjo, H.V., Kiyang, C.P., Djantou Biankeu, F.L., Guegang, C., Tchouotou, A.S.D., Wouambo, R.K., Thumamo Pokam, B.D., "Phenotypic Characterization and Prevalence of Carbapenemase-Producing Pseudomonas aeruginosa Isolates in Six Health Facilities in Cameroon". BioMed, 3(1), 77–88, Jan. 2023.
 
[13]  Froes, A.M., da Mota, F.F., Cuadrat, R.R., Davila, A.M., "Distribution and Classification of Serine beta-Lactamases in Brazilian Hospital Sewage and Other Environmental Metagenomes Deposited in Public Databases". Front. Microbiol., 7, 1760, Nov. 2016.
 
[14]  Cahill, N., O’Connor, L., Mahon, B., Varley, A., McGrath, E., Ryan, P., Cormican, M., Brehony, C., Jolley, K.A., Maiden, M.C et al., "Hospital effluent: A reservoir for carbapenemase-producing Enterobacterales?" Sci. Total Environ., 672, 618-624, Jul. 2019.
 
[15]  Haller, L., Chen, H., Ng, C., Le, T.H., Koh, T.H., Barkham, T., Sobsey, M., Gin, K.Y., "Occurrence and characteristics of extended-spectrum beta-lactamase- and carbapenemase- producing bacteria from hospital effluents in Singapore". Sci. Total Enviro., 615, 119–1125, 2018.
 
[16]  Yousfi, K., Touati, A., Lefebvre, B., Garneau, P., Brahmi, S., Gharout-Sait, A., Harel, J., Bekal, S., "Characterization of multidrug-resistant Gram-negative bacilli isolated from hospitals effluents: First report of a blaOXA-48-like in Klebsiella oxytoca, Algeria". Braz. J. Microbiol., 50(1), 175–183, Jan. 2019.
 
[17]  Nola, M., Noah Ewoti, O.V., Nougang, M., Mougang, M.L., Chihib, N-E., Krier, F., Servais, P., Hornez, J-P and Njine, T., "Involvement of cell shape and flagella in the bacterial retention during percolation of contaminated water through soil columns in tropical region". Journal of Environmental Science and Health Part A , 45, 1297–1306, 2010.
 
[18]  Nola, M., Noah Ewoti , O.V Nougang, M.E., "Assessment of the hierarchical involvement of chemical characteristics of soil layer particles during bacterial retention in Central Africa". Int. J. Environment and Pollution, 46, 178-198, 2011.
 
[19]  Eheth, J.S., Lontsi Djimeli, C., Moungang, L.M., Moussa Djaouda, Noah Ewoti, O.V., Tamsa Arfao, A., Nougang, M.E., Bricheux, G., Nola, M. and Sime-Ngando, T., "Assessment the role of some abiotic factors in the abundance dynamics of Pseudomonas aeruginosa in wells in sandy and clayey-lateritic soils in Cameroon (central africa)". International Journal of Information Research and Review, 3(5), 2343-2353, May 2016.
 
[20]  Emmanuel, E., Marie Gisèle, P., Perrodin, Y., "Groundwater contamination by microbiological and chemical substances released from hospital wastewater: Health risk assessment for drinkink water consumers". Environment International, 35(4), 718-726, May 2019.
 
[21]  Nlend, B., Celle-Jeanton, H., Humeau, F., Garel, E., Ngo Boum-Nkot, S., Etame, J., "Shallow urban aquifers under hyper-recharge equatorial conditions and strong anthropogenic contrains. Implications in terme of groundwater ressources potential and integrated water ressources management strategies". Sci. Total Environment, 757, 143887, Feb. 2021.
 
[22]  Chukwuebuka, E., , , H.I., "Investigating Groundwater Contamination Following the Disposal of Hospital Wastes in a Government Reserved Area, Enugu, Nigeria". Bull. Environ. Contam. Toxicol., 98(2), Feb. 2017.
 
[23]  Olivry, J.C., "Fleuves et rivières du Cameroun. Paris: Collection “Monographies 942 hydrologiques ORSTOM", 1986, p 781.
 
[24]  Sighomnou, D., "Analyse et Redéfinition des Régimes Climatiques et Hydrologiques du Cameroun: Perspectives D ’évolution des Ressources en eau". Thèse Doct., Etat. Univ. Yaoundé I, Cameroun, 2004, p. 289.
 
[25]  Fouépé Takounjou, A., Gurunadha Rao, V.V.S., Ngoupayou, J.N., Nkamdjou, S.L. and Ekodeck, G.E., "Groundwater flow modelling in the upper Anga’a river watershed, Yaounde, Cameroon". Ad. J. Environ. Sci. Tech., 9 (4), 1-12, 2018.
 
[26]  Regnoult, J.M., "Synthese geologigue du Cameroon. Yaounde: Ministere des Mines et Energie", 1986, p119.
 
[27]  Ndomè, E.P.E., "Mineralogy, Geochemistry and Geotechnical Applications of Weathering Products of Sedimentary Rocks of Douala". Ph.D. Thesis, Univ. Yaoundé I, Yaoundé, 2010, p212.
 
[28]  Dumort, J.C, "Notice explicative sur la feuille de Douala-Quest". Direction Mines et de la Geologie du Cameroun, Yaounde, 69, 56, 1968.
 
[29]  SNEC.: Societe´ Nationale des Eaux du Cameroun "Rapport technique sur les forages des Massoumbou". 1988.
 
[30]  Fantong, W.Y., Kamtchueng, B.T., Ketchemen-Tandia, B., Kuitcha, D., Ndjama, J., Fouepe, A.T., Takem, G.E., Mengnjo, I.J., Wirmvem, S.L., Bopda, D., Ako, A.A., Nkeng, G., Minoru, K. & Takeshi, O., "Variation of hydrogeochemical characteristics of water in surface flows, shallow wells, and boreholes in the coastal city of Douala (Cameroon)". Hydrol. Sci. J., 61, 16, 2916-2929, 2016.
 
[31]  Mafany, G.T., "Impact of the geology and seawater intrusion on groundwater quality in Douala". Thesis (M.Sc.). University of Buea, Cameroon, 1999, p252.
 
[32]  Braun, J-J., Ndam Ngoupayou, J.R., Viers, J., Dupre, B., Bedimo Bedimo, J-P., Boeglin, J-L et al. "Present weathering rates in a humid tropical watershed: Nsimi, South Cameroon". Geochim. Cosmochim Acta. 69(2), 357-387, Jan. 2005.
 
[33]  Mvondo Ondoa, J., "Caractérisation des évènements tectoniques dans le domaine Sud de la Chaine Panafricaine au Cameroun: Styles tectoniques et géochronologie des séries de Yaounde et de Bafia" Ph.D. thesis. University of Yaounde I. Cameroon, 2009. p247.
 
[34]  Ngoupayou, J.R.N., Bon, A.F., Mboudou Ewodo, G., Abdou, N.N,. and Ekodeck, G.E., "Hydrogeological Characteristics of Shallow Hard Rock Aquifers in Yaounde (Cameroon, Central Africa)". In Groundwater hydrology, chapter 1. Edited by Muhammad Salik Javaid, 2019.
 
[35]  Fouépé Takounjou, A., Fantong, W., Ndam, J. & Sigha Nkamdjou, L. "Comparative analysis for estimating hydraulic conductivity values to improve the estimation of groundwater recharge in Yaoundé-Cameroon". British Journal of Environment & Climate Change, 2 (4), 391–409, Jan. 2013.
 
[36]  Bon, A.F., Ngo Ngoss, T.A.M., Mboudou Ewodo, G., Banakeng, A.L., Ngoupayou, J.R.N., and Ekodeck G.E., "Groundwater flow patterns, hydrogeochemistry and metalsbackground levels of shallow hard rock aquifer in a humid tropical urban area in sub-Saharan Africa- A case study from Ol´ezoa watershed (Yaounde-Cameroon)". Hydrogeol. J.: Regional Studies, 37, 100904 b. Oct. 2021.
 
[37]  Segalen, P., "Les sols et géomorphologie du Cameroun". Cahier ORSTOM, sér. Péd. 988(2), 137–180, 1967.
 
[38]  Zogning A., "Les formations superficielles latéritiques dans la région de Douala: morphologie générale et sensibilité aux activités humaines". In: Séminaire régional sur les latérites: sols, matériaux, minerais: sessions 1 et 3. Paris: ORSTOM, 1987, p. 289-303.
 
[39]  Hieng, I.O., "Study of the geotechnical parameters of the soils of Cameroon. Edition CLE, Yaounde, Cameroon", 2003.
 
[40]  Ngueutchoua G., "Etude des faciès et environnements sédimentaires du quaternaire supérieur du plateau continental camerounais". Thèse de Doctorat Univ. Perpignan 4, Perpignan, 1996, 288 p.
 
[41]  Kamgang, B.K.; Ekodeck, G.E., Altération et bilans géochimiques des biotites des gneiss de Nkolbisson (NW de Yaoundé, Cameroun). Géodynamique. 6(2), 191–199, 1999.
 
[42]  CBCPS: Central Bureau of Censuses and Population Studies. Book "Presentation Report"(in French), 2010.
 
[43]  NIS (National Institute of Statistics). "Surface and groundwater quality in the city of Yaounde and its health impact". Publication of the Department of Demographic and Social Statistics (in French), Jun 2013.
 
[44]  MAAP (Mapping Antimicrobial resistance and Antimicrobial use Partnership). "Situation nationale de la résistance aux antimicrobiens et analyse de la consommation de 2017 à 2019". Rapport sur le Cameroun, 2022.
 
[45]  AHA (American Hospital Association). "Hospital Statistics". Chicago, 1986, 250 p.
 
[46]  Mansotte, F., Astagneau, P., Brucker, G., Brunel, C., Crignon, A.M., Feldman, P., Godard, M., Gourdet, V., Harel, A., Hofman, M., Lerouge, M., Paquette, A., Soulet, T., Vassal, S., Yakar, V., "Disposal of liquid effluents from hospitals. Recommendations from CLIN Paris-Nord". Paris, Cordeliers Biomedical Institute, 1999, 74 p.
 
[47]  MINEE (Minitère de l’Eau et de l’Energie, Ministry of Water and Energy). "Rapport diagnostic institutionnel, technique et financier de la Stratégie Nationale d’Assainissement liquide au Cameroun", 2011, Pp 30.
 
[48]  APHA (American Public Health Association). "Standard methods for the examination of water and waste water". APHA 22th Edition, Washington DC, 2012.
 
[49]  Goto, S., and Enomoto, S., "Nalidixic acid cetrimide agar. A new selective plating medium for the selective isolation of Pseudomonas aeruginosa". Microbiol. Immunol. 4, 65–70, 1970.
 
[50]  EN ISO 16266. "Water Quality – Detection and numeration of Pseudomonas aeruginosa – Method by membrane filtration", 2008.
 
[51]  Holt, J.G., Krieg, N.R., Sneath, P.H.A., Staley, J.T., Williams, S.T., "Bergey’s manual of determinative bacteriology". 9th edn. Lippincott Williams and Wikins Publications, Philadelphia, 2000.
 
[52]  EUCAST: European Committee on Antimicrobial Susceptibility Testing. ESCMID Edit. . Accessed 23 June 2021.
 
[53]  Krumperman, P.H., "Multiple antibiotic-resistance indexing of Escherichia coli to identify high-risk sources of fecal contamination of foods". Appl. Environ. Microbiol., 46 (1), 165-170, Jul. 1983.
 
[54]  Livermore, D.M., "β-lactamases in laboratory and clinical resistance". Clin. Microbiol. Rev., 8(4), 557—584, Oct. 1995.
 
[55]  Satoru, S., Phan, T.P., "Distribution of quinolones, sulfonamides, tetracyclines in aquatic environment and antibiotic resistance in Indochina". Front. Microbiol., 3, 67–70, Feb. 2012.
 
[56]  WHO (World Health Organisation). "Antimicrobial resistance global report on surveillance". Geneva: Switzerland, 2014.
 
[57]  WHO (World Health Organization). "Report on Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Dicovery, and Development of New Antibiotics". https:// www.who.int/ medicines/publications/global-priority-list-antibiotic-resistant-bacteria/en/. Accessed on 26 March 2023.
 
[58]  Gaze, W.H., Zhang, L., Abdouslam, N.A., Hawkey, P.M., Calvo-Bado, L., Royle, J., Brown, H., Davis, S., Kay, P., Boxall, A.B.A., "Impacts of anthropogenic activity on the ecology of class 1 integrons and integron-associated genes in the environment". ISME J., 5(8), 1253–1261, Aug. 2011.
 
[59]  Fuentefria, D.B., Ferreira, A.E., Corção, G., "Antibiotic-resistant Pseudomonas aeruginosa from hospital wastewater and superfcial water: are they genetically related?" J. Environ. Manag., 92(1), 250–255, Jan. 2011.
 
[60]  Ateba, N.S., Ngaba, G.P., Ebongue, C.O., Ngassongo, R.O., Tsiagadigui, J.G., Behiya, G., Nguepi, E., Adiogo, D., "Susceptibility to Colistin of Multi-Resistant Pseudomonas aeruginosa Isolated in Douala Laquintinie Hospital, Cameroon". Afr. J. Pathol. Microbiol., 2, 1-4, Jan. 2013.
 
[61]  Kamga, G.H., Michel, T., Zacharie, S., Jean Marie, N.N., Calixte, D.M., Dieudonné, A., "Caractérisation phénotypique des souches de Pseudomonas aeruginosa isolées dans la ville de Yaoundé (Cameroun)". Afr. J. Pathol. Microbiol. 4, 1-4, Jan. 2015.