Antibiotic-Resistant Escherichia coli in Drinking Water Samples from Rural Andean Households in Cajamarca, Peru.

Antibiotic resistance in pathogenic bacteria is a serious public health issue. The growing threat is a cause for concern and action to prevent the emergence of new resistant strains and the spread of existing ones to humans via the environment. This study aimed at identifying fecal pathogens in drinking water obtained from rural Andean households from Cajamarca, Peru, and measuring the antibiotic resistance profile of Escherichia coli. The study was embedded within a community-randomized controlled trial among 102 communities in the northern highlands of the Cajamarca region, Peru. Of 314 samples, 55.4% (95% CI [49.7, 61.0], n = 174) were identified as thermotolerant coliforms. Among the samples positive for thermotolerant coliform, E. coli was isolated in 37.3% (n = 117), Klebsiella spp. in 8.0% (n = 25), Enterobacter spp. in 5.1% (n = 16), and Citrobacter spp. in 2.5% (n = 8). Of the 117 E. coli samples, 48.7% (95% CI [39.4, 58.1], n = 57) showed resistance to any antibiotic. The E. coli antibiotic resistance profile showed highest resistance against tetracycline (37.6%), ampicillin (34.2%), sulfamethoxazole-trimethoprim (21.4%), and nalidixic acid (13%). Some 19.7% (95% CI [12.9, 28.0], n = 23) of the E. coli isolates displayed multidrug resistance, defined as resistance to at least three classes of antibiotics. The CTX-M-3 gene, which encodes extended-spectrum resistance to beta-lactamase antibiotics, was found in one isolate. The high prevalence of fecal contamination in drinking water highlights the importance of household water treatment methods. Likewise, the high levels of antibiotic resistance found indicate a need for further research to identify the origins of potential environmental contamination, misuse, or inadequate disposal of antibiotics.

Release of iron, zinc, and lead from common iron construction bars and zinc metallic bars in water solutions and meals.

BACKGROUND: The use of iron pots has decreased the prevalence of anemia. OBJECTIVE: To investigate the release of iron, zinc, and lead from metallic iron and zinc bars incubated in water and in meals. METHODS: Iron, zinc, and lead concentrations were measured at different incubation conditions in water and in meals. RESULTS: The iron concentration in water was 1.26 mg/L after incubation with one iron bar at pH 7 and 100 degrees C for 20 minutes and in meals was 0.97 mg per 100 g of wet meals, rich in phytate, cooking at 100 degrees C during 20 minutes. The maximum contents were 7720 mg/L of iron and 1826 mg/L of zinc in vinegar at pH 3 and 20 degrees C after 90 and 32 days, respectively. Lead was released from the bars, but at concentrations well below the upper tolerable limits. DISCUSSION: In outreach populations, the use of iron and zinc metallic bars in water and meals could contribute to sustainable, very low-cost prevention of iron and zinc deficiencies, and home-fortified vinegar could be used for treatment of both deficiencies. CONCLUSIONS: Field trials should be performed to determine the impact that the use of iron and zinc metallic bars in water and meals might have on the iron and zinc status of population groups.