Detection of carbapenemase gene from multidrug-resistant Pseudomonas aeruginosa isolated from hospital sewage waste water and adjacent community tap water

Abstract

Introduction: Hospital wastewater is a prime breeding ground for antibiotic-resistant pathogenic microorganisms. The goal of our study is to explore the multi drug resistance pattern of Pseudomonas aeruginosa discovered in both hospital and community water to anticipate how our routine commutes are being exposed. Methods: A total of 33 non-duplicate isolates of Pseudomonas aeruginosa were obtained from both the hospital and the surrounding community tap water. Initially, phenotype technique was used to identify multi-drug-resistant isolates. Antimicrobial susceptibility was detected by using the Kirby disk diffusion method. Each isolate was tested resistance to carbapenem, aminoglycosides, fluoroquinolones, lipopeptide, macrolides, beta-lactam combination agents, penicillin, and monobactam. The presence of the Metallo-beta-lactamase (MBLS) and Extended spectrum β-lactamase (ESBL) gene was determined using the traditional PCR method. Result: Out of 33 isolates collected from hospital wastewater and community water show a comparable antimicrobial-susceptibility pattern against the stated antibiotic classes. Only 15 were selected for further antimicrobial-susceptibility test against the stated antibiotic classes. Isolates found resistant to Amikacin (26.6%), Amoxyclav (93.3%), Azithromycin (100%), Aztreonam (66.6%), Cefepime (20%), Ceftazidime (20%), Ceftriaxone (53.3%), Chloramphenicol (55.5%), Ciprofloxacin (33.3%), Colistin (26.6%), Erythromycin (93.3%), Gentamicin (26.6%), Imipenem (20%), Norfloxacin (40%), Piperacillin-tazobactam (26.6%), Polymyxin (13.3%) and Tetracycline (46.6%). On the contrary, 4 isolates obtained from both Hospital waste water and adjacent Community Tap water showed resistance to most of the mentioned antibiotics. Those isolates were tested positive for the presence of bla-NDM, NDM- 1, bla-CTX-M, bla-OXA 48 and bla-TEM by PCR as, confirming the existence of a gene encoding extended spectrum beta-lactamase and MBL. Conclusion: The result of this study provided insights into the high proportion of NDM-1, OXA-48, CTX-M and TEM producers concluding that Hospital wastes have an impact on the emergence of new diseases by transmitting multidrug-resistant microorganisms to nearby areas, exposing the general population to antibiotic resistance at an early stage and making them resistant to any treatments.