Abstract
Universal access to safe water, whether at households or health centres, is central to achieving the sixth sustainable development goal by 2030. A hospital-based survey was conducted to screen for antimicrobial resistance among coliforms in samples collected from tap water (n = 54) at surgical wards in Gaza and to investigate the association with free residual chlorine and pH levels. Total coliforms (TC) were detected in 48.1% (26/54) of tested samples and FCs were detected in 25.9% (14/54). Free residual chlorine test ranged from zero to 0.2 mg/l (average: 0.08 mg/l), of which more than half of the samples (53.7%) 29/54 showed no free residual chlorine. The mean value of free residual chlorine in samples tested positive for growth on m-Endo (0.03) was lower than the mean for negative samples (0.14). The pH values were within the acceptable range (average: 7.6) and there was a statistically significant variation between the mean of pH values for samples tested positive on m-Endo (7.29) and that tested negative (7.84). Among coliform positive samples, 23.1% (6/26) had coliform isolates with resistance patterns. More than two-thirds of antimicrobial resistant (AMR) isolates were resistant to amikacin, ceftazidime, ceftriaxone, and imipenem. Moreover, 50% of the isolates were resistant to piperacillin-tazobactam. One-third (33.3%) of isolates were resistant to cefoxitin, and fosfomycin, 16.7% were resistant to ciprofloxacin, and nitrofurantoin. Intermediate resistance was shown in 16.7% of the isolates to cefoxitin and ciprofloxacin. The ESBL and carbapenem resistance genes detected in isolates were TEM (66.7%), NDM (33.3%), OXA (25%), blaCTXM (16.7%), and blaCTXM-3 (16.7%). The finding highlighted the level of contamination with AMR coliform in samples collected from tap water and pointed out the importance of managing water safety through identifying the main source of contamination, in addition to maintaining proper water disinfection at healthcare facilities for the patient, staff and environmental safety.
Highlights
Antimicrobials have been effective in reducing the morbidity and mortality attributed to infectious diseases
About 52% of the whole sample was collected from male surgery department and 48% was collected from female surgery department
Less than 10 CFU/100ml was detected for Total coliforms (TC) in about 80.8% of positive samples; and more than 100 CFU/100ml was detected for Faecal Coliforms (FC) in half (50%) of samples with positive growth on m-Endo
Summary
Antimicrobials have been effective in reducing the morbidity and mortality attributed to infectious diseases. Many studies in Gaza reviled high rates of antimicrobial resistance in both clinical and environmental samples collected either from hospitals or from communities [4] [5] [6]. Escherichia coli was among the prevailing microorganisms isolated from clinical samples with microbial resistance to first, second and third generation antibiotics [5] [7] [8] [9]. In Gaza, Gram-negative carbapenem resistance bacteria were detected in about 12% of clinical and environmental samples (14.4% in Klebsiella spp. and 9.8% in E. coli) [10]. More information about the level of contamination with resistant coliforms in water supplies needs to be available for effective infection control and prevention that can be caused by anti-microbial resistant (AMR) bacteria
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
