Comparison of antimicrobial resistance patterns between clinical and sewage isolates in a regional hospital in Taiwan

Yang, Chu‐Wen; Lin, Ming-Feng; Liao, P; Yeh, Hung-I; Chang, Bea‐Ven; Tang, Tian; Cheng, C. H.; Sung, Chih-Hung; Liou, Ming-Li

doi:10.1111/j.1472-765x.2009.02572.x

Cited by 57 publications

(44 citation statements)

References 27 publications

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“…HWW can be hazardous to public health since it may contain many kinds of pollutants such as radioactive, chemical and pharmaceutical wastes and pathogenic microorganisms 2 . Discharge of pathogenic microorganisms and un-metabolized antibiotics in low concentrations may also contribute to the development of antibiotic resistance in our natural microflora/environmental microflora 3,4 . The increasing of antibiotic resistance and the cause of the spread of resistance genes in environmental samples such as HWW is a result of uncontrolled and excessive use of antibiotics 5 .…”

Section: Introductionmentioning

confidence: 99%

Untreated Liquid Hospital Waste: Potential Source of Multidrug Resistant Bacteria

Siddiqui

Khatoon

Roy

2016

Bangla. J. Microbiol.

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Antimicrobial resistance in both pathogenic and commensal bacteria is increasing steadily. Failure of antibiotic resistant bacteria containment is responsible for this expansion. Healthcare effluent acts as the store house of harmful infectious pathogens. Potential health risk includes spreading of diseases by these pathogens and wide dissemination of antimicrobial resistance genes. The present study was carried out to investigate the multiple-drug resistance among the bacterial strains that were isolated and identified from the effluents of Jessore Medical College Hospital & Jessore Queen's hospital private limited. Identified bacteria were E. coli , Klebsiella spp., Enterobacter spp., Proteus vulgaris and Salmonella spp.. Occurrence of E. coli and Enterobacter spp. were found to have the highest percentages and present in majority of the samples. The identified organisms antibiotic resistant pattern were analyzed by agar disc diffusion method against 6 antibiotics. Results of antibiotic susceptibility test showed that all of the isolates were multi-drug resistant (e"4). From the study, we observed that 75% of the isolates were resistant to amoxicillin, followed by Ampicillin (64%), Chloramphenicol (31%), Gentamycin (29%), Nitrofurantoin (27%) and least resistant being Ciprofloxacin 23%. Among the isolates Salmonella spp. were showed highest rate of resistance against all the used antibiotics. The result denotes that, the identified bacteria have been well exposed to the tested antimicrobials and they have established mechanisms to avoid them. Therefore, proper waste water treatment plant should be established to diminish the risk of disseminating multiple drug resistant microorganisms for the safeguard of public health.

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Section: Introductionmentioning

confidence: 99%

Untreated Liquid Hospital Waste: Potential Source of Multidrug Resistant Bacteria

Siddiqui

Khatoon

Roy

2016

Bangla. J. Microbiol.

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“…WGS was often performed only on a small number of isolates and plasmids in these studies (18,26,27), limiting the genomic resolution of the analysis. Additionally, there have been limited studies comparing wastewater MDROs with patient isolates (18,(28)(29)(30)(31).…”

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confidence: 99%

Genomic Analysis of Hospital Plumbing Reveals Diverse Reservoir of Bacterial Plasmids Conferring Carbapenem Resistance

Weingarten

Johnson

Conlan

et al. 2018

mBio

180

134

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The hospital environment is a potential reservoir of bacteria with plasmids conferring carbapenem resistance. Our Hospital Epidemiology Service routinely performs extensive sampling of high-touch surfaces, sinks, and other locations in the hospital. Over a 2-year period, additional sampling was conducted at a broader range of locations, including housekeeping closets, wastewater from hospital internal pipes, and external manholes. We compared these data with previously collected information from 5 years of patient clinical and surveillance isolates. Whole-genome sequencing and analysis of 108 isolates provided comprehensive characterization of bla KPC /bla NDM -positive isolates, enabling an in-depth genetic comparison. Strikingly, despite a very low prevalence of patient infections with bla KPC -positive organisms, all samples from the intensive care unit pipe wastewater and external manholes contained carbapenemase-producing organisms (CPOs), suggesting a vast, resilient reservoir. We observed a diverse set of species and plasmids, and we noted species and susceptibility profile differences between environmental and patient populations of CPOs. However, there were plasmid backbones common to both populations, highlighting a potential environmental reservoir of mobile elements that may contribute to the spread of resistance genes. Clear associations between patient and environmental isolates were uncommon based on sequence analysis and epidemiology, suggesting reasonable infection control compliance at our institution. Nonetheless, a probable nosocomial transmission of Leclercia sp. from the housekeeping environment to a patient was detected by this extensive surveillance. These data and analyses further our understanding of CPOs in the hospital environment and are broadly relevant to the design of infection control strategies in many infrastructure settings.IMPORTANCE Carbapenemase-producing organisms (CPOs) are a global concern because of the morbidity and mortality associated with these resistant Gramnegative bacteria. Horizontal plasmid transfer spreads the resistance mechanism to new bacteria, and understanding the plasmid ecology of the hospital environment can assist in the design of control strategies to prevent nosocomial infections. A 5-year genomic and epidemiological survey was undertaken to study the CPOs in the patient-accessible environment, as well as in the plumbing system removed from the patient. This comprehensive survey revealed a vast, unappreciated reservoir of CPOs in wastewater, which was in contrast to the low positivity rate in both the patient population and the patient-accessible environment. While there were few patient-environmental isolate associations, there were plasmid backbones common to both populations. These results are relevant to all hospitals for which CPO colonization may not yet be defined through extensive surveillance.

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“…Hospital sewage represents an extremely selective environment where high rates of resistant bacteria are evacuated in the natural environment or through animal fecal wastes; both hospital sewage and fecal wastes, can be environmental vectors for the horizontal transfer of antibioticresistant genes via transduction by bacteriophages (24,25). Therefore, agents of antibiotic resistance are not only found in pathogenic bacteria but also in environmental organisms.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Methicillin-Resistant Staphylococcus aureus (MRSA) Phages From Sewage at a Tertiary Pediatric Hospital

Rahimzadeh¹,

Gill²,

Rezai³

2016

Arch Pediatr Infect Dis

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Comparison of antimicrobial resistance patterns between clinical and sewage isolates in a regional hospital in Taiwan

Cited by 57 publications

References 27 publications

Untreated Liquid Hospital Waste: Potential Source of Multidrug Resistant Bacteria

Untreated Liquid Hospital Waste: Potential Source of Multidrug Resistant Bacteria

Genomic Analysis of Hospital Plumbing Reveals Diverse Reservoir of Bacterial Plasmids Conferring Carbapenem Resistance

Characterization of Methicillin-Resistant Staphylococcus aureus (MRSA) Phages From Sewage at a Tertiary Pediatric Hospital

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