High prevalence of ESBL-Producing in private and shared latrines in an informal urban settlement in Dar es Salaam, Tanzania.

BACKGROUND

Data about the burden of extended-spectrum beta-lactamase (ESBL)-producing microorganisms in Africa are limited. Our study aimed to estimate the prevalence of human faecal ESBL carriage in the community of an informal urban settlement in Dar es Salaam (Tanzania, East Africa) by using environmental contamination of household latrines with ESBL as a surrogate marker.

METHODS

Within the context of a large survey in February 2014 assessing 636 randomly selected household latrines for faecal contamination by the detection of growth of and total faecal coliform bacteria, a randomly selected subset of the samples were screened for ESBL.

RESULTS

Seventy latrines were screened for ESBL. An average of 11.4 persons (SD ±6.5) were sharing one latrine. Only three (4.3%) latrines had hand-washing facilities and 50 showed faeces on the floor. ESBL-producing were confirmed in 17 (24.3%) of the 70 latrine samples: 16 and 1 Five ESBL strains were detected on door handles. The most prevalent ESBL type was CTX-M-1 group (76.5%). Pulsed-field gel electrophoresis typing of a subset of ESBL-producing isolates revealed both diverse singular types and a cluster of 3 identical isolates. There was no significant difference of the latrine and household characteristics between the group with ESBL ( = 17) and the group with non-ESBL ( = 53) ( > 0.05).

CONCLUSIONS

Almost a quarter of private and shared latrines in an informal urban settlement in Tanzania are contaminated with ESBL-producing microorganisms, suggesting a high prevalence of human ESBL faecal carriage in the community. Shared latrines may serve as a reservoir for transmission in urban community settings in Tanzania.