Universal access to safe water, whether at households or health centres, is central to achieving the sixth sustainable development goal by 2030. A hospital-based survey was conducted to screen for antimicrobial resistance among coliforms in samples collected from tap water (n = 54) at surgical wards in Gaza and to investigate the association with free residual chlorine and pH levels. Total coliforms (TC) were detected in 48.1% (26/54) of tested samples and FCs were detected in 25.9% (14/54). Free residual chlorine test ranged from zero to 0.2 mg/l (average: 0.08 mg/l), of which more than half of the samples (53.7%) 29/54 showed no free residual chlorine. The mean value of free residual chlorine in samples tested positive for growth on m-Endo (0.03) was lower than the mean for negative samples (0.14). The pH values were within the acceptable range (average: 7.6) and there was a statistically significant variation between the mean of pH values for samples tested positive on m-Endo (7.29) and that tested negative (7.84). Among coliform positive samples, 23.1% (6/26) had coliform isolates with resistance patterns. More than two-thirds of antimicrobial resistant (AMR) isolates were resistant to amikacin, ceftazidime, ceftriaxone, and imipenem. Moreover, 50% of the isolates were resistant to piperacillin-tazobactam. One-third (33.3%) of isolates were resistant to cefoxitin, and fosfomycin, 16.7% were resistant to ciprofloxacin, and nitrofurantoin. Intermediate resistance was shown in 16.7% of the isolates to cefoxitin and ciprofloxacin. The ESBL and carbapenem resistance genes detected in isolates were TEM (66.7%), NDM (33.3%), OXA (25%), blaCTXM (16.7%), and blaCTXM-3 (16.7%). The finding highlighted the level of contamination with AMR coliform in samples collected from tap water and pointed out the importance of managing water safety through identifying the main source of contamination, in addition to maintaining proper water disinfection at healthcare facilities for the patient, staff and environmental safety.
References
[1]
Tacconelli, E., Carrara, E., Savoldi, A., Harbarth, S., Mendelson, M., Monnet, D.L., et al. (2018) Discovery, Research, and Development of New Antibiotics: The WHO Priority List of Antibiotic-Resistant Bacteria and Tuberculosis. The Lancet Infectious Diseases, 18, 318-327. https://doi.org/10.1016/S1473-3099(17)30753-3
[2]
Capita, R. and Alonso-Calleja, C. (2013) Antibiotic-Resistant Bacteria: A Challenge for the Food Industry. Critical Reviews in Food Science and Nutrition, 53, 11-48. https://doi.org/10.1080/10408398.2010.519837
[3]
MacGowan, A.P. (2008) Clinical Implications of Antimicrobial Resistance for Therapy. Journal of Antimicrobial Chemotherapy, 62, ii105-ii114. https://doi.org/10.1093/jac/dkn357
[4]
Elmanama, A.A., Hartemann, P., Elnabris Kamal, J., Ayesh, A., Afifi, S., Fatma, E., et al. (2016) Antimicrobial Resistance of Staphylococcus aureus, fecal streptococci, Enterobacteriaceae and Pseudomonas aeruginosa Isolated from the Coastal Water of the Gaza Strip-Palestine. The International Arabic Journal of Antimicrobial Agents, 6, Article No. 2. https://doi.org/10.3823/792
[5]
Al Laham, N.A. (2012) Distribution and Antimicrobial Resistance Pattern of Bacteria Isolated from Operation Theaters at Gaza Strip. Journal of Al Azhar University-Gaza (Natural Sciences), 14, 19-34.
[6]
El Aila, N.A., Al Laham, N.A. and Ayesh, B.M. (2017) Nasal Carriage of Methicillin Resistant Staphylococcus aureus among Health Care Workers at Al Shifa Hospital in Gaza Strip. BMC Infectious Diseases, 17, Article No. 28. https://doi.org/10.1186/s12879-016-2139-1
[7]
Tayh, G., Ben Sallem, R., Ben Yahia, H., Gharsa, H., Klibi, N., Boudabous, A., et al. (2017) First Report of Extended-Spectrum β-Lactamases among Clinical Isolates of Klebsiella pneumoniae in Gaza Strip, Palestine. Microbial Drug Resistance, 23, 169-176. https://doi.org/10.1089/mdr.2016.0089
[8]
Hujier, A. and Saleem, N. (2006) Detection of Methicillin-Resistant Staphylococcus aureus in Nosocomial Infections in Gaza Strip. Islamic University, Gaza.
[9]
Elmanama, A.A., Alyazji, A.A. and Abu-Gheneima, N. (2011) Antibacterial, Antifungal and Synergistic Effect of Lawsonia inermis, Punica granatum and Hibiscus sabdariffa. Annals of Alquds Medicine, 7, 33-41.
[10]
Rida, R.H., Al Laham, N.A. and Elmanama, A.A. (2018) Carbapenem Resistance among Clinical and Environmental Gram-Negative Isolates Recovered from Hospitals in Gaza Strip. Palestine. GERMS, 8, 147-154. https://doi.org/10.18683/germs.2018.1142
[11]
Hutton, G. and Varughese, M. (2016) The Costs of Meeting the 2030 Sustainable Development Goal Targets on Drinking Water, Sanitation, and Hygiene. World Bank Group, Washington, DC. https://doi.org/10.1596/K8543
[12]
Palestinian Water Authority (2019) Water Safety for Public Health Status Joint Report. Gaza, Palestine.
[13]
World Bank (2017) Towards Water Security for Palestinians: A Diagnostic of Improvements Needed in Water and Sanitation Services in the West Bank & Gaza. World Bank Group, Washington, DC.
[14]
Shomar, R.A., Abdelatif, M. and Kishawi, Y. (2017) Visualising the Spatial Distribution of Diarrheal Disease Using the Geographical Information System: A WASH Perspective. International Journal of Global Environmental Issues, 16, 76-90. https://doi.org/10.1504/IJGENVI.2017.083421
[15]
Office for the Coordination of Humanitarian Affairs (OCHA) (2020) Two Years on: People Injured and Traumatized During the “Great March of Return” Are Still Struggling.
[16]
Costal Municpalities Water Utilities (2018) Costal Municipalities Water Utilities: Annual Report 2017. Costal Municpalities Water Utilities, Palestine, Gaza.
[17]
Ministry of Health (2019) Evaluation of Water Quality in Gaza Governorates. Environmental Health Department, Gaza, Palestine.
[18]
UNICEF (United Nations Children’s Fund) and WeWorld-GVC (2019) WASH Assessment and Surveillance System in Health Faciliteis in the Gaza Strip. UNICEF, Gaza Strip.
[19]
Centers for Disease Control and Prevention (CDC) (2020) Free Chlorine Testing. https://www.cdc.gov/safewater/chlorine-residual-testing.html
[20]
New South Wales (2004) Approved NSW Recovery Plan: Davidson’s Plum (Davidsonia jerseyana). Department of Environment and Conservation, Sydney.
[21]
Barrie, A., Swaray, A., Barrie, M. and Beah, J. (2021) Evaluating Drinking Water Treatment Methods in the Njala University and Neighboring Mokonde Communities in Southern Sierra Leone. Natural Resources, 12, 257-270. https://doi.org/10.4236/nr.2021.128019
[22]
World Health Organization (2011) Guidelines for Drinking-Water Quality. Vol. 38, WHO Chronicle. 4th Edition, World Health Organization, Geneva, 104-108.
[23]
Palestinian Centreal Bureau of Statistics (2021) Palestinian Multiple Indicator Cluster Survey 2019-2020, Survey Findings Report. Palestinian Centreal Bureau of Statistics, Ramallah.
[24]
Kanth, M.K., Sing, S.K., Kashyap, A., Gupta, V.K., Shalini, S., Kumar, S., et al. (2017) Microbial Study of Drinking Water in the Government Hospitals of Patna District, Bihar, India. American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS), 38, 161-167. https://doi.org/10.1016/j.ibiod.2017.05.024
[25]
Bergeron, S., Raj, B., Nathaniel, R., Corbin, A. and LaFleur, G. (2017) Presence of Antibiotic Resistance Genes in Raw Source Water of a Drinking Water Treatment Plant in a Rural Community of USA. International Biodeterioration & Biodegradation, 124, 3-9. https://doi.org/10.1016/j.ibiod.2017.05.024
[26]
Zhang, H., Zhou, Y., Guo, S. and Chang, W. (2015) Multidrug Resistance Found in Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae from Rural Water Reservoirs in Guantao, China. Frontiers in Microbiology, 6, Article No. 267. https://doi.org/10.3389/fmicb.2015.00267
[27]
Bird, K., Boopathy, R., Nathaniel, R. and LaFleur, G. (2019) Water Pollution and Observation of Acquired Antibiotic Resistance in Bayou Lafourche, a Major Drinking Water Source in Southeast Louisiana, USA. Environmental Science and Pollution Research International, 26, 34220-34232. https://doi.org/10.1007/s11356-018-4008-5
