Contribution of Hospital Wastewater to the Spread of Antibiotic Resistance in Comparison to Non-Health Institution

Abstract

A potential post-antibiotic era is threatening present and future medical advances. The current worldwide increase in resistant bacteria and, simultaneously, the downward trend in the development of new antibiotics have serious implications. This research conducted to study the resistance profile of bacterial isolates from wastewater samples effluent from Al-Shifa hospital in Gazaas a health institution and comparing their profile with bacteria isolated from wastewater samples effluent from anon-health institution. In this study, wastewater sample were collected from three different sewers receiving wastewater in Al-Shifa hospital, from three sewers receiving wastewater in Islamic universityof Gaza(IUG), from inlet and outlet of Gazawastewater treatment plant (WWTP) and from seawater. A total of 45 samples were collected and the total number of different bacterial species that was isolated was 154 different bacteria. From the isolated bacteria 30.5% E. coli, 33.1% Pseudomonas spp., 10.4% Klebsiella spp., 4.5% Proteus spp. and 21.4% Enterococcus spp. Isolates were subjected to antimicrobial susceptibility testing. the percent of resistance for Gram-negative bacteria to 15 antibiotics were as the following Cephalexin (52.1%), Co-Trimoxazole (41.3%), Tetracycline (41.3%), Chloramphenicol (39.7%), Nalidixic Acid (36.4%), Piperacillin (28.9%), Amoxycillin (35.5%), Ceftizoxime (14.0%), Azreonam (13.2%), Ciprofloxacin (12.4%), Tobramycin (11.6%), Gentamicin (10.7%), Ceftazidime and Amikacin (8.3%) and Imipenem (0.0%). The percent of resistance for Gram-positive bacteria (Enterococcus) to 5 antibiotics were as the following: Streptomycin (91.0%), Vancomycin (75.8%), Erythromycin (60.6%), Teicoplanin (9.1%) and Ampicillin (6.1%). In conclusion we demonstrated that bacteria isolates from wastewater samples from Al-Shifa hospital and Laboratory building of IUG had higher number of antibiotic resistant bacteria than bacterial isolates from other sites.