Wastewater systems are gaining recognition as a critical transport medium for bacterial pathogens, alongside antimicrobial resistance genes and pharmaceutical residues. This public health risk is especially high in regions with limited wastewater treatment and sanitation infrastructure like Ethiopia. The propagation of infectious diseases and antimicrobial resistance via wastewater directly contributes to the mounting global health challenge significantly affecting local healthcare systems.
This article seeks to assess the prevalence of bacterial pathogens and their multidrug resistance patterns within wastewater and drinking water systems in Ethiopia, focusing on both hospital and non-hospital environments. A comprehensive sweep of electronic databases and grey literature was conducted, from which eligible studies were assessed. Analysis conducted on the collected data reveal disturbing trends.
The most commonly identified bacterium in the studies was Pseudomonas aeruginosa (or related species), with a prevalence of 41.25%. Overall, the wastewater systems housed a staggering 70.02% of bacterial pathogens while also exhibiting substantial diversity. The overall prevalence of multidrug-resistant bacterial strains in wastewater was also alarming at 65.26%.
These findings highlight the urgent requirement for enhanced wastewater management and monitoring to mitigate these public health threats. Future research needs to focus on homogenizing methodologies and investigating the sources of discrepancies to effectively manage the risks related to wastewater systems. Environmental reservoirs, including wastewater systems, facilitate the global spread of bacterial pathogens and antimicrobial resistance genes. This poses significant challenges for developing countries like Ethiopia.
Addressing the spread and emergence of antibiotic resistance is a top priority for the World Health Organization (WHO), considering the profound implications for the efficacy of antimicrobials in preventing and treating infections. For mitigating the impact on public health, rigorous evaluation, treatment, and monitoring of discharged wastewater are essential. The striking figures underscore the need for improved wastewater management and responsible antibiotic use. Future research needs to focus on homogenizing methodologies and investigating the sources of discrepancies to effectively manage and mitigate the risks associated with wastewater systems.
Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-10660-9