Dare to dive in? Antibiotic resistant bacteria in recreational water in Gothenburg, Sweden

Abstract

BACKGROUND Antibiotic resistant bacteria constitute a major global public health threat. Certain environments and settings contribute to the dissemination of such bacteria, and of antibiotic resistance genes. Understanding how pathogens acquire resistance, and when and where humans are exposed to such pathogens in a way that can cause colonization and infection, is crucial in tackling antibiotic resistance. AIM This study examined bacteria exhibiting resistance to fluoroquinolones or with phenotypic resistance resembling ESBL/ESBLCARBA in public swimming pools and in freshwater lakes used for recreational activities in the Gothenburg area. MATERIALS AND METHODS Water samples were cultivated on media selecting for gram negative and gram positive bacteria as well as enterococci. Gram negative bacteria were tested for resistance towards cefotaxime, meropenem, temocillin, and ciprofloxacin. RESULTS In all but one lake, bacteria exhibiting resistance to at least one antibiotic was found. Resistance against cefotaxime was most commonly found. Gram negative bacteria was more prevalent after incubation in 30 ℃ compared to 37 ℃. No viable bacteria was found in pools. DISCUSSION Chlorination of public pools seems effective in killing bacteria. Using freshwater lakes for recreational activities may constitute a risk for acquiring antibiotic resistant bacteria. IMPLICATIONS More research is needed to understand the risk for colonization and symptomatic infection associated with using lakes and pools for recreational activities. There is also a need to evaluate protocols for cultivation of water from lakes and pools.