Infections by Extended-Spectrum Beta-Lactamase producing Escherichia coli (ESBL-Ec) are on the increase in Ghana, but the level of environmental contamination with this organism, which may contribute to growing Antimicrobial Resistance (AMR), is unknown. Using the WHO OneHealth Tricycle Protocol, we investigated the contamination of E. coli (Ec) and ESBL-Ec in two rivers in Ghana (Odaw in Accra and Okurudu in Kasoa) that receive effluents from human and animal wastewater hotspots over a 12-month period. Concentrations of Ec, ESBL-Ec and percent ESBL-Ec/Ec were determined per 100 mL sample. Of 96 samples, 94 (98%) were positive for ESBL-Ec. concentrations per 100 mL (MCs100) of ESBL-Ec and %ESBL-Ec from both rivers were 4.2 × 10⁴ (IQR, 3.1 × 10³–2.3 × 10⁵) and 2.79 (IQR, 0.96–6.03), respectively. MCs100 were significantly lower in upstream waters: 1.8 × 10⁴ (IQR, 9.0 × 10³–3.9 × 10⁴) as compared to downstream waters: 1.9 × 10⁶ (IQR, 3.7 × 10⁵–5.4 × 10⁶). Both human and animal wastewater effluents contributed to the increased contamination downstream. This study revealed high levels of ESBL-Ec in rivers flowing through two cities in Ghana. There is a need to manage the sources of contamination as they may contribute to the acquisition and spread of ESBL-Ec in humans and animals, thereby contributing to AMR.

Introduction: Safety of the environment in which vegetables are grown, marketed and consumed is paramount as most are eaten raw. Irrigation sources include open drains and streams, which are often contaminated with human and animal waste due to poor sanitation infrastructure. In irrigated vegetable farms using such sources in Ghana, we assessed Escherichia coli counts, antibiotic resistance patterns and resistant genes on irrigated lettuce. Methods: A cross-sectional study was conducted between January–May 2022, involving five major vegetable farms in Ghana. Results: Escherichia coli was found in all 25 composite lettuce samples analyzed. Counts expressed in CFU/g ranged from 186 to 3000, with the highest counts found in lettuce irrigated from open drains (1670) and tap water using hose pipes (3000). Among all bacterial isolates, resistance ranged between 49% and 70% for the Watch group of antibiotics, 59% for the Reserved group and 82% were multidrug-resistant. Of 125 isolates, 60 (48%) were extended-spectrum beta-lactamase-producing, of which five (8%) had the bla_TEM-resistant gene. Conclusions: Lettuce was contaminated with Escherichia coli with high levels of antibiotic resistance. We call on the Ghana Ministry of Food and Agriculture, Food and Drugs Authority and other stakeholders to support farmers to implement measures for improving vegetable safety.

Antimicrobial resistance (AMR) surveillance plays a critical role in tracking emerging trends and informing evidence-based policies. This study assessed bacterial contamination and resistance profiles of Escherichia coli and Pseudomonas aeruginosa in 1886 drinking water samples from 12 regions of Ghana between April 2024 and April 2025. Findings were compared to a baseline study from the Greater Accra region (2022). Water samples analysed included sachet, bottled, tap, borehole, well, and surface water. Isolates were tested for antibiotic susceptibility using the Kirby–Bauer disk diffusion method. The majority of treated and packaged water samples were free from bacterial contamination. E. coli was frequently detected in untreated surface water (68%) and well water (63%). E. coli isolates from untreated water samples exhibited high resistance to cefuroxime (74%) and amoxicillin-clavulanate (50%); resistance to gentamicin increased from 3% in 2022 to 35% in 2025, while ertapenem resistance rose from 6% to 18%. Multidrug-resistant (MDR) E. coli isolates were found in samples from eight regions, and MDR P. aeruginosa in three, mostly from borehole water. These findings highlight the urgency to integrate AMR surveillance into national water quality initiatives, along with coordinated public health interventions, to educate communities on household water treatment practices and the health risks posed by AMR.