Abstract
Antibiotic resistance (AR) is a critical global health threat exacerbated by complex human-animal-environment interactions. Aquatic environments, particularly surface water systems, can serve as reservoirs and transmission routes for AR bacteria. This study investigated the prevalence of AR E. coli in Sinking Creek, a pathogen-impacted creek in Northeast Tennessee. Water samples were collected monthly from four sites along the creek over a 6-month period. E. coli isolates were cultured, identified, and tested for susceptibility to eight antibiotics using the Kirby-Bauer disk diffusion method and broth disk elution method for colistin. Data were analyzed to determine the prevalence of AR and multidrug resistance (MDR) among isolates. Of the 122 water samples, 89.3% contained E. coli. Among the 177 isolates tested, resistance was highest to ciprofloxacin (64.2%) and nitrofurantoin (62.7%), and lowest to fosfomycin (14.1%) and colistin (6.0%). Significant differences in resistance to ceftriaxone and amoxicillin/clavulanic acid were observed between sampling sites. MDR was prevalent in 47.5% of isolates, with 5.1% resistant to seven antibiotics. The most frequent MDR patterns (6.8%) included three antibiotics: ceftriaxone, ciprofloxacin, and nitrofurantoin. The high prevalence of AR E. coli in Sinking Creek poses a significant public health risk, highlighting the need for ongoing surveillance and intervention strategies to prevent the spread of AR bacteria.