COVID-19 arose at the time of great concern about Antimicrobial resistance (AMR). Despite the fact that little evidence on the impact of antimicrobials use for the treatment of COVID-19 is available, infection prevention and control policy include use of antimicrobials. The increasing use of antimicrobials and biocides for COVID-19 treatment or environmental disinfection may result in high proportion of these compounds in surrounding wastewater, and increase in AMR. We believe that Hospital wastewater contents in residual antimicrobial compounds and antimicrobial resistance determinants s may correlate with their levels of antimicrobial consumption in Cameroon during the COVID-19 outbreak.
Hospitals effluents will be collected in the two cities recording the highest numbers of COVID-19 cases in Cameroon. In each, 02 healthcare facilities receiving COVID-19 patients for treatment and 02 not involved in COVID-19 management will be selected for the study. Wastewater samples will be screened for detection and quantification of AMR genetic determinants using metagenomics analysis. The diversity and load of antimicrobials residues in the samples will be evaluated using Liquid Chromatography coupled with Mass Spectrometry. Based on the magnitude of AMR determinants and antimicrobial residues in the sawages samples, a modelling approach relying on an agglomerative hierarchical clustering analysis will be developed to estimate the antimicrobial consumption level in the selected healthcare facilities. The Bland-Altman analysis coupled to the calculation of the risk quotients will be used to assess the potential environmental and human health risk posed by the released of antimicrobial determinants and residues in surface water bodies. We expect to propose an innovative and non-human related tool for estimating antimicrobial consumption in healthcare facilities using hospital effluents and for providing timely informations on the dissemination of AMR in risk populations.