Abstract
Indiscriminate use of antibiotics has resulted in a catastrophic increase in the levels of antibiotic resistance in India. Hospitals treat critical bacterial infections and thus can serve as reservoirs of multidrug resistant (MDR) bacteria. Hence, this study was conducted to gauge the prevalence patterns of MDR bacteria in hospital wastewater. Water samples collected from 11 hospitals and 4 environmental sources belonging to 5 most-densely populated districts of West Bengal, India were grown on MacConkey and Eosin Methylene Blue agar. A total of 84 (hospital-associated = 70, environmental water sources = 14) isolates were characterized. The predominant species found in water from hospital-associated areas (HAA) were Acinetobacter baumannii (22.9%), Escherichia coli (28.6 %), and Klebsiella pneumoniae (25.7%). Greater than 75% of the HAA isolates were found to be mcr-1 gene negative and colistinresistant. Meropenem non-susceptibility was also high among the HAA isolates at 58.6%, with the presence of the carbapenemase gene and blaNDM in 67.1% of the non-susceptible isolates. Among the three predominant species, significantly higher numbers of E. coli isolates were found to be non-susceptible to meropenem ((80%), p-value = 0.00432) and amikacin (AK (90%), p-value = 0.00037). This study provides evidence for the presence of high numbers of colistin-resistant and carbapenem-hydrolyzing Proteobacteriain hospital wastewater.
Highlights
Antimicrobial resistance (AMR) is a global health challenge of the 21st century, and India contributes majorly to it [1,2]
This study provides evidence for the presence of high numbers of colistin-resistant and carbapenem-hydrolyzing Proteobacteriain hospital wastewater
This study was conducted in the fourth-most populous Indian state of West Bengal, and the objectives of this study were to understand: (i) the gram-negative species distribution, ii) antimicrobial resistance profiles, including colistin, and iii) β-lactamase gene carriage, and among the gram-negative bacterial isolates found in water samples collected from hospital wastewater out-falls and/or hospital ponds belonging to five districts, and contrast them with environmental water sources (EWS) in an unbiased manner, without selecting specific isolates resistant to any particular class of antimicrobial
Summary
Antimicrobial resistance (AMR) is a global health challenge of the 21st century, and India contributes majorly to it [1,2]. India has a high burden of bacterial diseases, in addition to which, misguided overuse of antibiotics is rampant [3]. It is one of the three leading consumers of antibiotics among low to middle-income countries across the world, with the highest usage of broad-spectrum penicillins [4]. In the animal production industry, polymyxins are routinely used as growth promoters [5,6]. Under such contrasting usage practices, both foodborne pathogens and high human usage of antibiotics can impact human health [7]. An understanding of the bacterial population distribution is imperative for better treatment design
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