Abstract
Antimicrobial resistance (AMR) represents a critical global health challenge, with projections suggesting 10 million annual deaths by 2050. Environmental transmission routes, particularly through wastewater, remain understudied despite their significant role in resistance development and spread. This study investigated household wastewater as a sentinel for community-level AMR patterns in Gombe, Nigeria. A cross-sectional study was conducted between December 2024 and February 2025, collecting 320 household wastewater samples across seven districts in Gombe using multi-stage sampling techniques. Bacterial isolation followed standard conventional methods. Antibiotic susceptibility testing was performed using the disc diffusion method. Extended-spectrum beta-lactamase (ESBL) production was confirmed using double-disc synergy tests, and PCR detected key resistance genes in selected isolates. Microbiological analysis yielded 402 bacterial isolates, with 81% classified as multidrug-resistant (MDR). MDR prevalence across districts ranged from 60.3% to 95.9% (p < 0.01). Gram-negative bacteria predominated, with Escherichia coli (32.7%), Klebsiella pneumoniae (19.2%), and Pseudomonas aeruginosa (11.2%) being the most common. ESBL production was detected in 54% of tested isolates. MDR isolates demonstrated resistance to approximately 8 antibiotics (median), while non-MDR isolates showed resistance to only 1–2 antibiotics. Molecular analysis revealed a high prevalence of clinically significant resistance genes, with blaCTX-M detected in 100% of tested isolates. This study demonstrates household wastewater’s value as a community-level antimicrobial resistance indicator. The high prevalence of MDR bacteria (81%) highlights significant environmental reservoirs that could contribute to community AMR transmission. Wastewater-based epidemiology can serve as a cost-effective complement to traditional clinical surveillance, especially in resource-limited settings.
Data availability
The datasets generated and/or analysed during the current study are not publicly available due to privacy and ethical restrictions but are available from the corresponding author upon reasonable request.
Abbreviations
- AMR:
-
Antimicrobial Resistance
- MDR:
-
Multidrug-Resistant
- ESBL:
-
Extended-Spectrum Beta-Lactamase
- PCR:
-
Polymerase Chain Reaction
- CLSI:
-
Clinical Laboratory Standards Institute
- EUCAST:
-
European Committee on Antimicrobial Susceptibility Testing
- LGA:
-
Local Government Area
- MAR:
-
Multiple Antibiotic Resistance
- LMICs:
-
Low-and Middle-Income Countries
- AST:
-
Antimicrobial Susceptibility Testing
- DDST:
-
Double Disc Synergy Test
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Acknowledgements
The authors wish to acknowledge the support of the staff of the Gombe State Environmental Protection Agency (GOSEPA) for granting ethical approval and facilitating community access during the fieldwork. We also thank the participating households for their cooperation and the technical staff of the Microbiology Laboratory at Gombe State University for their assistance with sample processing and bacterial identification.
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ZM conducted the sample collection, laboratory and data analysis, and jointly conceptualised the research with MTA, LG, and TAU. MTA, LG, and TAU also contributed to the study design and methodology. MKU, SSA, IY critically reviewed and revised the manuscript. SSA and IY provided technical advice and support throughout the study. All authors read and approved the final manuscript.
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This study was approved by the Gombe State Environmental Protection Agency (GOSEPA), Nigeria. The ethical approval reference number is ES/GOSEPA/ADM/S/38/V.I. All procedures involving environmental sampling were conducted in accordance with national and international guidelines for environmental health research. Although no human participants or biological tissues were directly involved in the study, verbal informed consent was obtained from the heads of households before wastewater sample collection. Participants were informed about the purpose of the study, assured of confidentiality, and their voluntary participation was respected. The need for written consent was waived by the ethics committee due to the non-invasive nature of environmental sampling and absence of identifiable human data.
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Muhammad, Z., Adamu, M.T., Garba, L. et al. Household wastewater as a sentinel for community-level antimicrobial resistance: a cross-sectional study in Gombe, Nigeria. Sci Rep (2026). https://doi.org/10.1038/s41598-025-29778-6
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DOI: https://doi.org/10.1038/s41598-025-29778-6