Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Effluents of Different Hospitals Sewage in Biratnagar, Nepal

Abstract

Untreated water from hospitals of Biratnagar as effluent is a serious concern from health point of view. Antimicrobial resistant bacteria are a serious threat which may contaminate the drinking water and environment. With an aim of isolation and detection of Multidrug resistance (MDR) and Extended-spectrum lactamases (ESBL) producing Enterobacteriaceae from the effluents and sewage samples of hospitals, this study builds the importance to inquiry about the involvement of hospital liquid waste discharge in the development and distribution of antibiotics resistance in the environment bacteria. Ten hospital sewage samples were aseptically collected, processed and analyzed. Isolates were biochemically identified, and their antimicrobial activity were tested. Of the ten sewage samples analyzed, 23 bacteria isolates were isolated which contained 8 Escherichia coli (34.7%), 5 isolates each of Citrobacter spp (21.7%) andEnterobacter spp (21.7%), 3 isolates of Klebsiella spp (13%), and 1 isolate each of Shigella spp (4.3%) and Yersinia spp (4.3%). Most of the bacteria isolated were resistant to ampicillin, ceftazidime, cefpodoxime, amoxicillin/clavulanate, cefotaxime, cefoxitin, ceftriaxone, and cefuroxime. The isolates were sensitive to nitrofurantoin, azithromycin, trimethoprim/sulfamethoxazole, chloramphenicol, ciprofloxacin, ofloxacin, and gentamycin antibiotics. Out of twentythree isolates, 16 (69.6%) were found to be multidrug resistant, 7 (30.4%) were producing extended beta lactamase, while 18 (78.3%) multi-antibiotics resistance index greater than 20%. Among the bacteria isolated; 80% of the Citrobacter; and 75% of the E. coli were found biofilm producing bacteria. Sewage treatment plant must be established in hospital for their effluents and sludge coming from the hospital.

Occurrence and Anti-Microbial Susceptibility Pattern of Extended Spectrum Beta‑Lactamase Producing Enterobacteriaceae in Governmental Hospitals Wastewater in Addis Ababa, Ethiopia

“…Of 147 Enterobacteriaceae family isolates recovered the highest distributions were from; laboratory unit 32 (21.8%) and mixed source e uent 30 (20.4%); whereas, the least isolates were recovered from MDR TB ward e uent 7 (4.8%), which was only collected from ALERT. In this study, the highest number of isolated bacteria, irrespective of total sample collected, were recovered from Y12HMC (34) and MIIRH (32); while, the least isolates were obtained from TASH (21) (Table 1).…”

“…(29.2%), E. coli (12.3%) and Enterobacter spp. (3.1%) (32), in Mekelle: from untreated hospital wastewater Klebsiella spp (25.9%), and E. coli (21.2%) (33), in Biratnagar, Nepal; from e uents of different hospitals sewage E. coli (34.7%), Citrobacter (21.7%), Enterobacter (21.7%), and Klebsiella (13%) (34). These variations might be due to sample type (inanimate object and swage of hospital), study period, sample size and type of pathogen infecting patients at time of sample collection.…”

Occurrence and Anti-microbial Susceptibility Pattern of Extended Spectrum Beta‑Lactamase Producing Enterobacteriaceae in Waste Water Released from Governmental Hospital of Addis Ababa, Ethiopia

“…In the present study the most frequent Enterobacteriaceae isolates were E. coli (45.6%), K. pneumoniae ( (37). These variations might be due to sample type (inanimate object and swage of hospital), study period, sample size and type of pathogen infecting patients at time of sample collection.…”

“…However, our nding dissimilar with a study carried out in China (E. coli (91.4%) and K. pneumoniae (94.1%)) (33), Ibadan, Nigeria (E. coli (94.8%)) (39), and in Biratnagar, Nepal (Enterobacter spp. (100%)) (37), where the highest MDR proportion for E. coli, K. pneumonia and Enterobacter spp. were indicated.…”

“…(60%), Citrobacter spp. (40%) and E. coli (25%)(37). This variation is occurred because of the difference of, wastewater type (hospital Vs municipality), source of wastewater contaminant, the prevalence of microbes, geographical location and disease epidemiology.The occurrence of ESBLs producers differ strongly within different species of Enterobacteriaceae.…”