A pilot environmental survey across three Ivorian cities detected carbapenemase-encoding genes in 62% of urban drainage water samples. The findings point to an environmental pathway for critical antibiotic resistance determinants beyond clinical settings. For industry audiences, the implication is operational: hospital waste and urban runoff can contribute to community spread of high-risk resistance genes, complicating containment strategies. The study also increases urgency around wastewater treatment performance and monitoring design, especially in regions where surveillance networks may not consistently cover environmental reservoirs.