Comparative Analysis of Multidrug Resistance Micro-Organisms Prevalence in Hospital Waste Water and Household Sewage Water
Md Yeasin Aman
Md Yeasin Aman, Department of Environmental Health and Wash, International Centre for Diarrhoeal Disease Research, Bangladesh
Rayhan Chowdhury
Rayhan Chowdhury, Department of Applied Laboratory Sciences, Bangladesh University of Health Sciences (BUHS), Bangladesh
Asaduzzaman Hridoy
Asaduzzaman Hridoy, Department of Anthropology, Comilla University, Bangladesh
Subrina Sultana Prema
Subrina Sultana Prema, Department of Microbiology, Gono Bishwabidyalay, Bangladesh
Sadia Islam
Sadia Islam, Department of Laboratory Medicine, Bangladesh Specialized Hospital PLC, Bangladesh
Md. Ashiqur Rahman
Md. Ashiqur Rahman, Department of Laboratory Medicine, Novus Clinical Research Services Limited, Dhaka, Bangladesh
DOI: https://doi.org/10.59429/mmr.v3i1.10183
Keywords: Multidrug-resistant bacteria, Hospital wastewater, Antibiotic resistance, Sewage contamination, Public health threat
Abstract
Background: In Bangladesh, antibiotic resistance is a growing health concern, driven by the indiscriminate use of antibiotics without prescriptions or proper dosage. This misuse, along with untreated hospital wastewater (HWW) containing antimicrobial residues, contributes to the spread of antibiotic-resistant bacteria in the environment. Hospital and household sewage can serve as reservoirs for these resistant bacteria, posing a risk to public health. Objective: To isolate and identify common bacterial species from hospital and household sewage, assess their antibiotic susceptibility, and compare multidrug resistance between hospital and household wastewater. Methods: Sewage samples from hospital and household sources were collected from various locations in the Saver zone over three months. After enrichment, the samples were plated on selective media (MacConkey, EMB, Cetrimate, TCBS, SS agar). Bacterial colonies were identified based on morphology and confirmed through biochemical tests. Antibiotic susceptibility was tested using the Kirby-Bauer disc diffusion method, with 13 antibiotics assessed for multidrug resistance. The process took about three months. Results: The prevalence of bacterial isolates was as follows: E. coli (15.05% in hospital, 15.22% in household), Klebsiella spp. (18.28% in hospital, 17.39% in household), Salmonella spp. (16.13% in hospital, 10.87% in household), Shigella spp. (12.90% in hospital, 10.87% in household), Vibrio spp. (11.83% in hospital, 8.70% in household), Pseudomonas spp. (11.83% in hospital, 17.39% in household), and Staphylococcus spp. (13.98% in hospital, 19.57% in household). Among the antibiotics tested, Azithromycin (AZM), Ciprofloxacin (CIP), and Cefixime (CFM) were the most effective. Over 80% resistance was observed for other antibiotics. All isolates were multidrug-resistant, with hospital sewage showing slightly higher resistance levels compared to household sewage. Conclusion: The study underscores the role of hospital wastewater in spreading multidrug-resistant bacteria, with higher resistance observed in hospital sewage. Antibiotic misuse is a major factor driving resistance, posing a significant public health threat. Effective antibiotic management and wastewater treatment are urgently needed.
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