A landscape view on antimicrobial resistance pattern of Acinetobacter baumannii and Vibrio cholerae in hospital wastewater and adjacent household water

Abstract

Global threats to public health are growing from carbapenem-resistant Gram-negative bacteria, particularly the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae- Vibrio cholerae. Numerous multidrug-resistant strains of V. cholerae and A. baumannii have been found in both clinical and environmental settings. One of the six most significant multidrug resistant pathogens found in hospitals around the world, Acinetobacter baumannii is known for its opportunistic nosocomial infection causing abilities and Cholera is caused by the bacterium called Vibrio cholerae, which places a significant burden on global public health, particularly in developing nations like Bangladesh. The current study aims to isolate and assess the prevalence of multidrug resistant A. baumannii and V. cholerae in hospital wastewater and its adjacent household water samples from three hospitals in the heart of Dhaka-City. Throughout the study which lasted from December 2022 to February 2023, 78 confirmed A. baumanni and 60 confirmed V. cholerae isolates have been identified using PCR. These isolates were further subjected to an antibiotic susceptibility test using various first line antibiotics. All the confirmed isolates for both organisms showed great resistivity to Erythromycin and Cefixime. The resistance outcome for A. baumannii and V. cholerae are as follows: Gentamicin (0%) and (1.67%), Amikacin (1.54%) and (1.67%), Imipenem (7.69%) and (6.67%), Cefixime (89.74%) and (80%), Ceftazidime (14.1%) and (16.67%), Cefepime (24.36%) and (8.33%), Amoxicillin Clavulanic acid (21.79%) and (15%), Doxycycline (6.41%) and (20%), Aztreonam (15.38%) and (3.33%), Erythromycin (73.08%) and (100%). Furthermore, MDR genes were also detected using PCR; 1 isolate found positive for blaNDM-1 and 2 for bla-CTX-M has been found out of 29 suspected A. baumannii. On the other hand, 1 isolate has been detected for blaKPC and blaNDM-1 out of 7 suspected V. cholerae. Hence, this study highlights current developments and suggests new directions for future study, including the reservoir of carbapenem-resistant bacteria. It places a special emphasis on the evolutionary and genomic features of A.baumannii and V. cholerae in three hospitals in Dhaka City.