Monitoring Multi-Drug Resistant in Kitagata Hot Spring, Southwestern Uganda: A Public Health Implication.

Background: The concerning frequency of in various recreational settings, is noteworthy, especially regarding multi-drug resistant (MDR) strains. This superbug is linked to the rapid spread of plasmids carrying these resistance genes. The objective of this study was to evaluate the spatiotemporal prevalence of MDR- in the Kitagata hot spring, Southwestern Uganda.

Methods: A laboratory-based descriptive longitudinal study was conducted between May and July 2023. During rainy and dry seasons, we collected eighty water samples in the morning and evening from the hot spring. The temperature at each point was measured prior to sample collection, and two samples were obtained at varying depths. 5 mL of each homogenized sample were pre-enriched in brain heart infusion broth, and subsequently in both blood and violet red bile agar. The Kirby-Bauer disk diffusion method was performed, followed by the detection of carbapenemase (CR) and extended-spectrum β-lactamase (ESBL) production. Polymerase chain reaction showed resistance genes and . Data were analyzed using SPSS-20 to obtain chi-square tests and regression analysis.

Results: accounted for 30.0% of isolates obtained from Kitagata hot springs, with all isolates classified as multi-drug resistant. All isolates were resistant to ampicillin, rifampicin, ceftazidime, and azithromycin (79.2%). Additionally, 95.8% of isolates harbored gene alone and both and genes, followed by alone (33.3%), with 25% harboring all three resistance genes. During the dry season, had a higher prevalence (35.0%) compared to the wet season (25.0%). The prevalence of MDR- significantly increased over the course of the study. The presence of the three studied resistance genes in the isolates showed a positive correlation with the second phase of sample collection and the dry season but exhibited a negative correlation with temperature, except for isolates harboring either alone or genes.

Conclusion: Kitagata hot spring serves as a hotspot for continuous dissemination and acquisition of MDR- harboring resistance genes that encode for ESBL and CR production. The healthcare sector ought to implement an ongoing monitoring and surveillance system as well as robust antimicrobial resistance stewardship programs aimed at delivering health education to the community.