The role of drinking water in the transmission of antimicrobial-resistantE. coli

Abstract

SUMMARYTo determine whether drinking water contaminated with antimicrobial-resistantE. coliis associated with the carriage of resistantE. coli, selected households sending water samples to Ontario and Alberta laboratories in 2005–2006 were asked to participate in a cross-sectional study. Household members aged ⩾12 years were asked to complete a questionnaire and to submit a rectal swab. In 878 individuals, 41% carried a resistant strain ofE. coliand 28% carried a multidrug-resistant strain. The risk of carriage of resistantE. coliwas 1·26 times higher for users of water contaminated with resistantE. coli. Other risk factors included international travel [prevalence ratio (PR) 1·33], having a child in nappies (PR 1·33), being male (PR 1·33), and frequent handling of raw red meats (PR 1·10). Protecting private water sources (e.g. by improving systems to test and treat them) may help slow the emergence of antimicrobial resistance inE. coli.