Abstract Description

The rise in antibiotic resistance by bacteria poses a major challenge to public health, especially in healthcare settings. Key ESKAPE bacteria linked to multidrug-resistant nosocomial infections include Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. These bacteria are known for their interaction with various organisms, aiding their spread. The housefly, Musca domestica, has been identified as a mechanical vector for multiple pathogens. This study sought to determine the prevalence and antibiotic resistance profiles of ESKAPE bacteria carried by M. domestica in a hospice and a nearby waste dump site in Krugersdorp, Gauteng. A total of 50 M. domestica, captured with sticky traps from both sites, were examined internally and externally for ESKAPE contamination. Antibiotic susceptibility testing was then performed using the Kirby-Bauer method. MALDI-TOF and species-specific gene sequencing confirmed 106 isolates from hospice (55.7 %) and waste dump (44.3 %). The prevalence rate was P. aeruginosa (76.3 %), K. pneumoniae (11.9 %), E. faecium (10.2 %), and E. cloacae (1.7 %) at the hospice. Whilst P. aeruginosa (80.8%), K. pneumoniae (12.8 %), and E. faecium (6.4%) were prevalent at the waste dump site. The overall prevalence rate of multidrug-resistant isolates was 15.3 % and 25.5 % at the hospice and waste dump site, respectively. The E. faecium isolates showed resistance to vancomycin, beta-lactams, and fluoroquinolones. The Gram-negative species showed resistance to beta-lactams, aminoglycosides, and fluoroquinolones, except E. cloacae, which showed no resistance. The M. domestica is a significant mechanical vector for multidrug-resistant ESKAPE bacteria, and their presence in both nosocomial settings and surrounding unsanitary environments poses a risk of cross-transmission, leading to infections in vulnerable patients in hospices and other healthcare facilities. The study recommends implementing and maintaining strict pest control measures in these settings to prevent infections with multidrug-resistant ESKAPE pathogens carried by insects.