Untreated water from hospitals of Biratnagar as effluent is a serious concern from health point of view. Antimicrobial resistant bacteria are a serious threat which may contaminate the drinking water and environment. With an aim of isolation and detection of Multidrug resistance (MDR) and Extended-spectrum lactamases (ESBL) producing Enterobacteriaceae from the effluents and sewage samples of hospitals, this study builds the importance to inquiry about the involvement of hospital liquid waste discharge in the development and distribution of antibiotics resistance in the environment bacteria. Ten hospital sewage samples were aseptically collected, processed and analyzed. Isolates were biochemically identified, and their antimicrobial activity were tested. Of the ten sewage samples analyzed, 23 bacteria isolates were isolated which contained 8 Escherichia coli (34.7%), 5 isolates each of Citrobacter spp (21.7%) andEnterobacter spp (21.7%), 3 isolates of Klebsiella spp (13%), and 1 isolate each of Shigella spp (4.3%) and Yersinia spp (4.3%). Most of the bacteria isolated were resistant to ampicillin, ceftazidime, cefpodoxime, amoxicillin/clavulanate, cefotaxime, cefoxitin, ceftriaxone, and cefuroxime. The isolates were sensitive to nitrofurantoin, azithromycin, trimethoprim/sulfamethoxazole, chloramphenicol, ciprofloxacin, ofloxacin, and gentamycin antibiotics. Out of twentythree isolates, 16 (69.6%) were found to be multidrug resistant, 7 (30.4%) were producing extended beta lactamase, while 18 (78.3%) multi-antibiotics resistance index greater than 20%. Among the bacteria isolated; 80% of the Citrobacter; and 75% of the E. coli were found biofilm producing bacteria. Sewage treatment plant must be established in hospital for their effluents and sludge coming from the hospital.
Objective This study was aimed to determine prevalence and resistance pattern like multidrug resistant (MDR) or ESBL nature of E. coli and Klebsiella spp. from various sewage drain samples with an idea to deliver baseline information that could be utilized for defining guidelines for the treatment of hospital sewages. Results Of 10 sewage samples analyzed, 7 (70%) contained E. coli while 6 (60%) contained Klebsiella. Except one sample, all positive samples contained both E. coli and Klebsiella spp. E. coli isolates were resistant to ampicillin, amoxicillin, cefoxitin, cefuroxime, and cefpodoxime; while 85.7% were resistant to amoxicillin/clavulanate, ceftazidime, cefotaxime and ceftriaxone. 71.4%, 57.1%, 42.9%, and 28.6% were resistant to aztreonam, trimethoprim/sulfamethoxazole, nitrofurantoin, and gentamicin. Most were sensitive to chloramphenicol, ofloxacin, ciprofloxacin, and azithromycin. 85.7% and 57.1% of E. coli were MDR and ESBL isolates, respectively. Klebsiella were resistant to ampicillin, amoxicillin, and amoxicillin/clavulanate. 83.4% of Klebsiella were resistant to cefoxitin. 66.7% of strains were resistant to cefuroxime, ceftazidime, cefotaxime, ceftriaxone, and cefpodoxime. Klebsiella showed 50% resistant to aztreonam and trimethoprim/sulfamethoxazole, while 33.3% were resistant to chloramphenicol, nitrofurantoin, ofloxacin, and ciprofloxacin. Klebsiella were sensitive to azithromycin and gentamicin. 66.7% and 33.3% of Klebsiella were MDR and ESBL isolates, respectively.
Introduction: Urinary Tract Infection (UTI) causes inflammation which is a common, painful and sometimes life-threatening condition as well. Despite high prevalence of bacteriuria, the information on biofilm forming bacteria is negligible. Objectives: This study aims at understanding the status of the biofilm forming nature of Klebsiella spp and Pseudomonas SPP and their drug resistance property with several class of antibiotics with a prime focus on resistance pattern against few penicillin based drugs to few empirical drugs in today's time. Methodology: Urine samples were analyzed and the isolates were biochemically identified. Then, the isolates were tested for several drugs so as to identify multidrug resistance nature of isolates by Kirby-Bauer Disc method. Biofilm forming nature was examined on Congo Red Agar. Results Out of 35 urine samples, 13 isolates (37.1%) were found to be positive with significant bacteriuria. Eight samples (22.8%) showed incidence of Klebsiella spp. and 5 samples (14.3%) showed P. aeruginosa. The prevalence of Klebsiella spp. (Klebsiella pneumoniae (46.2%) and K. oxytoca(15.4%)) and P. aeruginosa was found to be 61.4% and 38.6% respectively. 66.6% of K. pneumoniae and 50% K. oxytocawere biofilm forming pathogen.K. pneumoniae andK. oxytoca were resistant to amoxycillin, amoxycillin-clavulanate, and cefoxitin; while were sensitive to nitrofurantoin and azithromycin.P. aeruginosa were sensitive to azithromycin(100%), but showed 60% resistance to levofloxacin and ofloxacin. Eight (61.5%) isolates were found to be MDR. 100% of Klebsiella oxytoca (n=2), 66.7% of Klebsiella pneumoniae (n=4), and 40% of Pseudomonas aeruginosa (n=2)were multidrug resistant (MDR).Multiple antibiotic resistance (MAR) indices of bacteria revealed that all the 13 isolates were Multi-Antibiotics Resistance strains. Conclusion Biofilm forming nature is now much greater in Klebsiella spp; while most of the isolates like Klebsiella and Pseudomon as are multidrug resistant.
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