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埃塞俄比亚巴赫达尔市两家专科医院医院废水中细菌的抗菌药物耐药性概况

Antimicrobial resistance profile of bacteria from hospital wastewater at two specialized hospitals in Bahir Dar city, Ethiopia.

作者信息

Endalamaw Kirubel, Tadesse Senait, Asmare Zelalem, Kebede Destaw, Erkihun Mulat, Abera Bayeh

机构信息

Department of Diagnostic Laboratory, Shegaw Motta General Hospital, East Gojjam, Motta Town, PO Box 50, Ethiopia.

Department of Medical Microbiology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, PO Box 79, Ethiopia.

出版信息

BMC Microbiol. 2024 Dec 19;24(1):525. doi: 10.1186/s12866-024-03693-8.

Abstract

BACKGROUND

The high levels of antimicrobial consumption in hospitals contribute to the occurrence of antimicrobial resistant bacteria. Antimicrobial resistant bacteria and sub-lethal concentrations of antimicrobial metabolites can end up in hospital wastewater which can spread to the environment and to the community. However, information on the resistance profile of bacteria isolated from environments is not well studied. Thus, the main aim of this study was to determine the antibiotic resistance profile of bacteria from hospital wastewater in Bahir Dar City, Northwest Ethiopia.

METHOD

A total of 70 hospital wastewater samples were collected from two comprehensive specialized hospitals using a grab-sampling technique. Bacteria were identified using colony morphology, Gram staining, and biochemical tests. The drug susceptibility test was performed using the Kirby-Bauer disc diffusion method on Muller-Hinton agar.

RESULT

The most dominant bacterial isolates from hospital wastewater were Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Citrobacter spp., Acinetobacter spp., Enterobacter spp., Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa). All K. pneumoniae and 52.4% (11/21) E. coli were resistant to ceftazidime (third-generation cephalosporin), while Citrobacter spp., Acinetobacter spp., and Enterobacter spp., were susceptible to ceftazidime. Likewise, S. aureus revealed 64% (16/25) resistance to erythromycin. Overall, 22.2% of bacterial isolates were multidrug resistant bacteria to the commonly prescribed antimicrobials.

CONCLUSION

Hospital waste waters contain high prevalence of multiple drug-resistant bacteria, particularly the third-generation cephalosporin resistant K. pneumoniae and E. coli would be a big concern. Infection prevention and control practices with proper treatment of hospital wastewater before discharging should be in practice to contain the spread of drug-resistant bacteria from hospital to external environment.

摘要

背景

医院中高水平的抗菌药物消耗导致了抗菌药物耐药菌的出现。抗菌药物耐药菌和亚致死浓度的抗菌代谢产物最终会进入医院废水,这些废水可能会扩散到环境和社区中。然而,关于从环境中分离出的细菌的耐药谱信息尚未得到充分研究。因此,本研究的主要目的是确定埃塞俄比亚西北部巴赫达尔市医院废水中细菌的抗生素耐药谱。

方法

采用抓取采样技术,从两家综合专科医院共采集了70份医院废水样本。通过菌落形态、革兰氏染色和生化试验鉴定细菌。采用 Kirby-Bauer 纸片扩散法在 Muller-Hinton 琼脂上进行药敏试验。

结果

医院废水中最主要的细菌分离株为金黄色葡萄球菌、大肠杆菌、柠檬酸杆菌属、不动杆菌属、肠杆菌属、肺炎克雷伯菌和铜绿假单胞菌。所有肺炎克雷伯菌和52.4%(11/21)的大肠杆菌对头孢他啶(第三代头孢菌素)耐药,而柠檬酸杆菌属、不动杆菌属和肠杆菌属对头孢他啶敏感。同样,金黄色葡萄球菌对红霉素的耐药率为64%(16/25)。总体而言,22.2%的细菌分离株对常用抗菌药物具有多重耐药性。

结论

医院废水含有高比例的多重耐药菌,特别是对第三代头孢菌素耐药的肺炎克雷伯菌和大肠杆菌,这将是一个重大问题。应实施感染预防和控制措施,并在排放前对医院废水进行适当处理,以遏制耐药菌从医院向外部环境的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd13/11657465/5e3d17b53cb9/12866_2024_3693_Fig1_HTML.jpg

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