Prevalence of antimicrobial-resistant Escherichia coli and Enterococcus species in pigs in northern Malawi, and the knowledge, attitudes and practices (KAP) amongst butchers

Abstract

The prevalence of multidrug-resistant (MDR) opportunistic pathogens in many of the sub-Saharan countries has been one of the compelling reasons for proper mapping and management of the disease in hotspot areas. This study investigated the prevalence of antimicrobial-resistant Escherichia coli and Enterococcus species isolated from pigs in the northern part of Malawi and analysed the knowledge, attitudes and practices (KAP) of butchers concerning good hygienic practices. The KAP questionnaire was administered to 75 participants and 232 caecal samples were collected from pigs slaughtered at randomly selected slaughter places in Nkhata Bay, Rumphi, Mzimba, Karonga, and Mzuzu city. Overall KAP scores for knowledge, attitude, and practices were 81%, 73% and 46%, respectively. A positive correlation between the butchers’ knowledge and their attitude (r = .46, p<0.001), knowledge and practices (r = .38, p<0.001), and attitude and practices (r = .76, p<0.001) was observed. Microbiological tests confirmed the presence of Escherichia coli and Enterococcus species by biochemical tests. Escherichia coli resistance to ampicillin was high (82.2%) and this was followed by trimethoprim-sulfamethoxazole (75.8%), gentamicin (22.5%), cefotaxime (13.1%), ciprofloxacin (7.9%), and tigecycline (0.5%). In terms of Enterococcus species, resistance to vancomycin, ampicillin and ciprofloxacin were at 79.7%, 50% and 23.4%, respectively. No resistance to tigecycline was observed in all the Enterococcus isolates. The study also found that 26.7% (n=51) and 10.1% (n=16) of the E. coli and Enterococcus isolates, respectively, were resistant to more than one class of antibiotics. The study revealed a high risk of cross-contamination with resistant pathogens. Therefore, good hygienic practices in the farm-to-fork continuum, enforcement of food safety regulations and capacity building are pivotal in reducing the dissemination of resistant genes in the pork chain. The importance of antimicrobial stewardship should not be underemphasized if optimal utilisation of antimicrobials is to be attained.