Perfis de resistência de coliformes em praias costeiras urbanas de Fortaleza (CE): relevância para a abordagem da Saúde Única (One Health)

Abstract

The sanitary quality of beach environments is relevant to ensuring safe primary contact use by the population, guaranteeing public health. Simultaneously, it is important that this quality is also maintained to provide environmental health, preventing the contamination of ecosystems; thus, the One Health approach becomes increasingly relevant for the adoption of integrated monitoring. CONAMA Resolution No. 274/2000 provides microbiological parameters for water, but not for sand, although this assessment is already recommended by the World Health Organization (WHO). This research aimed to estimate the quantity of thermotolerant coliforms (TTC) in water and wet sand samples from beaches in Fortaleza (CE), as well as to identify them and trace an antimicrobial resistance profile. Two collections were carried out: the first during the dry season and the second during the rainy season, at Caça e Pesca (P1), Futuro (P2), Iracema (P3) and Meireles (P4) beaches. Eight antimicrobials were used: Azithromycin, Doxycycline, Sulfamethoxazole-trimethoprim, Levofloxacin, Amikacin, Meropenem, Ceftriaxone, and Nalidixic Acid. During the dry season, the highest MPN value for water was from P1, with 78 MPN/100 mL; for wet sand, all points had between 3.0 and 3.5 MPN/g of total solids. During the rainy season, 2800 MPN/100 mL of thermotolerant coliforms were detected in the water of Caça e Pesca, the highest value among the environments analyzed, while in the sand samples the highest values found were: 430 MPN/g and 230 MPN/g on beaches P1 and P3, respectively. Among the coliform bacteria isolates, the predominant species was Escherichia coli, except for P4, which had a higher presence of Enterobacter spp. The results of the antibiogram test revealed 22 resistant strains (29.3% of the total) to at least one antimicrobial, with 6 of them resistant to two or more drugs. Reduced susceptibility was mainly observed for nalidixic acid and doxycycline. Two strains isolated from the rainy season, originating from the sand of P1, showed resistance to 4 antibiotics commonly used for treatments of the gastrointestinal, respiratory and urinary tracts. The calculation of the Multidrug Resistance Index (MRA) revealed a potential risk of contamination. The results indicate a considerable risk from both contact with water and sand, especially in P3 and P1, where the quantity of resistant bacteria was higher. Concrete actions by public authorities are necessary, coupled with new approaches based on One Health, in order to promote collective well-being and preserve ecological homeostasis.