Deciphering Antimicrobial Resistance in Ghana Using Wastewater: A pilot study using digital and molecular detection innovations

The Decipher AMR Project

Funded by:

Partner/collaborator:

Outline of the meeting

1. The MIRAHI Program
2. Overview of Decipher AMR Project
3. Results from our project

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Making Innovation a Reality – Africa Health Initiative (MIRAHI)

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What is MIRAHI?

Why Decipher and Diaxxo?

Who is behind MIRAHI?

• MIRAHI is an initiative to support Innovators have an impact on Healthcare challenges in Sub-Saharan Africa with a focus on Swiss technologies
• MIRAHI brings together entrepreneurial innovators and the healthcare system to explore what challenges exist and help validate if the entrepreneurial solutions can have an impact and explore further ways to develop them

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• Decipher had interest and competence in AMR monitoring and engaging with the public and healthcare system in Ghana.
• Diaxxo had a technology that could make an impact on AMR and other challenges but which had not been validated in African conditions.
• In addition it was possible to engage the local academic ecosystem

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How Do We Become Better Responsive to Bacterial Infectious Diseases?

Hospital care = Individualized healthcare

Community health =

Public Health

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A new way of AMR Surveillance Using Wastewater

Can wastewater be used for AMR surveillance in LRS?

How do we decipher the nexus of AMR using digital tech and high throughput molecular detection in Ghana?

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Wastewater Sample collection

Animal farm

Environmental source: open drains

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Rapid Sample to Results Powered by Diaxxo PCR innovation

Diaxxo POD PCR

Diaxxo DNA extraction machine

Sample extraction, PCR pathogen identification in less than 1 hr

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Decipher AMR Wastewater surveillance Demographic Data

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Regional Distribution of E. coli ESBL Genes

Fig 2: Distribution of E. coli in wastewater in 5 regions in Ghana

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E. coli ESBL ARG Distribution in Hospital, Animal and Environmental wastewater

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How significant are these E. coli ESBL ARG distributions: in sources of water

• Samples collected from the hospitals are more likely to test positive to GES as compared to samples from the environment.

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• Also, samples that tested positive for GES & TEM are more likely to be collected at the hospital setting as compared to samples collected from the environment.

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How significant are these E. coli ESBL ARG distributions: in the Regions

There is no statistical significance between the regions and the E. coli ESBL ARGs

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What does this data mean?

• The co-colonization of E. coli with ESBL-TEM & GES in animals (a major food system) is a worrying observation.
• ESBL-TEM (prevalent in clinical E. coli) found in hospital wastewater and animal wastewater is an indication of environmental spillover of ESBL-TEM.
• The emergence of ESBL-GES in E. coli obtained from hospital wastewater.
• ESBL-GEM is a resistance prevalent in P. aeruginosa.

Thank you!

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Q&A

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