Antibiotic Resistance Patterns of <i>Escherichia coli</i> from Children’s Sandpits in Durban, South Africa: A Point Prevalence Study

<b>Background/Objectives</b>: Although children’s playgrounds foster physical, cognitive and emotional health, sandpits can harbour antibiotic-resistant bacteria, representing a health concern for kids. Therefore, this point prevalence study investigated the presence and antimicrobial resistance of <i>Escherichia coli</i> in sandpits at four schools in Durban to ascertain the potential risk to schoolchildren and inform school authorities of the need to prevent such occurrences. <b>Methods</b>: Twenty samples were collected from schools on a single day. <i>E. coli</i> was isolated using colilert-18^® and confirmed using PCR. Antibiotic susceptibility testing was performed against 19 antibiotics using the disc diffusion method and Clinical and Laboratory Standards Institute (CLSI) guidelines. <b>Results</b>: <i>E. coli</i> was detected in 2/4 schools (50%), yielding 100 pure isolates. Of these, 71% (31 Site B and 40 Site C isolates) were resistant to at least one of the antibiotics tested, displaying 36 antibiograms. The highest resistance was to CFX (<i>n</i> = 40), and the lowest was to AMK and MEM (<i>n</i> = 1). All isolates were susceptible to CIP, CHL, GEN and TZP. At Site B, the highest resistance was against CFX (<i>n</i> = 16) and the lowest against AMK, CTX and NAL (<i>n</i> = 1). The highest resistance at Site C was against TET (n = 26), and the lowest against ATH and AUG (<i>n</i> = 1). Twenty isolates (20%) were multidrug-resistant, displaying resistance to at least one antibiotic from 3 classes. <b>Conclusions</b>: These results show that children with poor hygiene practices could get sick from playing in sandpits. Schools must change their sand regularly and ensure that sandpits are constantly exposed to the sun.