Prevalence of Extended-Spectrum β-Lactamase-Producing , and in Wastewater Effluent in Blantyre, Malawi.

: Wastewater treatment plants (WWTPs) serve as a sink for both antimicrobial residues and bacteria carrying resistant genes, which are later disseminated into the environment, facilitating the spread of antimicrobial resistance. This study investigated the presence of extended-spectrum beta-lactamase (ESBL) producing , , and in effluent from WWTP in Blantyre, Malawi, to generate evidence and provide baseline information for interventions. : Selective chromogenic agar was used to identify ESBL-producing bacteria. : A total of 288 samples were collected between April 2023 and March 2024, and 97.6% (281/288) yielded one or more presumptive ESBL isolates. Bacterial growth was confirmed as 48.9% (255/522), 33.0% (172/522), and 10.0% (52/522). Antibiotic susceptibility testing showed the highest resistance to ceftriaxone (, 100.0%; , 98.3%; , 100.0%) and the lowest resistance to meropenem (, 6.3%, , 1.2%; , 3.8%) among the antibiotics that were tested. Multiple antibiotic resistance phenotypes were observed in 73.1% of the isolates, with the most prevalent phenotype being amoxicillin + clavulanate/cotrimoxazole/doxycycline/ciprofloxacin/gentamicin/azithromycin/ceftriaxone (55, 15.7%). : The study demonstrated ongoing environmental contamination with antibiotic-resistant bacteria from sewage effluent. Therefore, the functionality of WWTPs should be improved to minimize the release of these organisms into the environment.