The Alarming Reality of Antibiotic Resistance Bacteria in Hospital Wastewater

 Introduction:

Hospital wastewater (HWW) is an often-overlooked source of antibiotic resistance bacteria (ARB) and antibiotic resistance genes (ARGs) that pose a significant threat to public health. In a recent study conducted in Kathmandu, Nepal, researchers sought to shed light on the concerning prevalence of antibiotic resistance in hospital effluents.

Research Methodology:

The study involved collecting and analysing wastewater samples from four different hospitals. The goal was to determine the antibiotic resistance patterns of the bacteria present. Total viable bacteria were isolated and identified using the tryptone soya agar culture medium. Furthermore, antibiotic resistance bacteria were isolated by introducing specific antibiotics into the medium, including ampicillin, ciprofloxacin, doxycycline, sulfamethoxazole, and ceftriaxone. Antibiotic susceptibility testing was performed using the Kirby Bauer disc diffusion method.

Findings:

The study revealed several noteworthy findings:

• Total viable bacterial counts in hospital wastewater samples exceeded standard heterotrophic plate counts.
• The highest prevalence of antibiotic resistance bacteria varied depending on the antibiotics used in different hospital samples.
• Among the identified bacterial colonies, the most dominant species were Pseudomonas spp (23.8%) and Bacillus spp (17.68%).
• A significant percentage of isolates, particularly Citrobacter, Shigella, E. coli, and Pseudomonas spp, were multidrug-resistant (MDR).
• Ampicillin and ceftriaxone exhibited the highest resistance rates among the isolated bacteria.

Implications: The study raises several critical concerns:

• Hospital effluents were often discharged into nearby rivers without prior treatment, potentially contributing to the spread of ARB in the environment.
• Even hospitals with wastewater treatment systems did not effectively eliminate ARB from their effluents.
• The presence of MDR bacteria in hospital wastewater highlights the gravity of the issue, as these bacteria are resistant to multiple antibiotics.
• The study suggests that Gram-negative bacteria were frequently resistant to ampicillin and ceftriaxone, while Gram-positive bacteria exhibited resistance to ampicillin and cotrimoxazole.

Conclusion: The research underscores the urgent need for improved management of hospital wastewater to mitigate the spread of antibiotic resistance bacteria. Hospitals must prioritize effective treatment of their effluents before discharge. Additionally, monitoring and control measures are necessary to prevent the transmission of ARB to the community, as these bacteria pose a significant public health threat.

As antibiotic resistance continues to rise, addressing the issue at its source, including within hospital settings, is of paramount importance to safeguard public health and prevent the proliferation of antibiotic-resistant bacteria in the environment.

 - Kusha Gurung