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Hospital Wastewater Releases of Carbapenem-Resistance Pathogens and Genes in Urban India.
Lamba, Manisha; Graham, David W; Ahammad, S Z.
Afiliação
  • Lamba M; Department of Biochemical Engineering and Biotechnology, Indian Institute of Technology Delhi , Hauz Khas, New Delhi, 110016, India.
  • Graham DW; School of Civil Engineering & Geosciences, Newcastle University , Newcastle upon Tyne, NE1 7RU, United Kingdom.
  • Ahammad SZ; Department of Biochemical Engineering and Biotechnology, Indian Institute of Technology Delhi , Hauz Khas, New Delhi, 110016, India.
Environ Sci Technol ; 51(23): 13906-13912, 2017 Dec 05.
Article em En | MEDLINE | ID: mdl-28949542
ABSTRACT
Increasing antibiotic resistant hospital-acquired infections and limited new antibiotic discovery are jeopardizing human health at global scales, although how hospitals themselves fuel antimicrobial resistance (AMR) in the wider environment is largely unknown. Antibiotic resistance (AR) in hospitals in countries such as India is potentially problematic because of high antibiotic use, overcrowding, and inadequate wastewater containment. Here we quantified fecal coliforms (FC), carbapenem-resistant Enterobacteriaceae (CRE), blaNDM-1, and selected extended-spectrum ß-lactam (ESBL) resistant bacteria and genes in 12 hospital wastewater outfalls and five background sewer drains across New Delhi over two seasons. Hospital wastewaters had up to 9 orders of magnitude greater concentrations of CRE bacteria and blaNDM-1 than local sewers (depending on the hospital), implying hospitals contribute high concentrations of AR relative to community sources in Delhi, especially during the winter. Significant correlations were found between FC levels (a fecal indictor), and CRE (r = 0.924; p = 0.005), blaNDM-1 (r = 0.934, p = 0.009), and ESBL-resistant bacteria (r = 0.913, p = 0.010) levels across hospital wastewaters, respectively, implying that elevated CRE and blaNDM-1 are of patient origin. However, of greater importance to global health, microbial culturing found 18 to 41% of wastewater CRE isolates (n = 1447) were on the WHO "critical pathogen" list in urgent need of new antibiotics, and 55% of CRE isolates from larger hospitals carried at least one blaNDM-1 gene. Wastewater releases from New Delhi hospitals may pose a greater AR exposure risk to residents than believed, implying in-hospital antibiotic use must be better controlled and more effective waste treatment is needed for hospital wastewaters.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Resistência Microbiana a Medicamentos / Carbapenêmicos / Águas Residuárias Limite: Humans País como assunto: Asia Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Resistência Microbiana a Medicamentos / Carbapenêmicos / Águas Residuárias Limite: Humans País como assunto: Asia Idioma: En Ano de publicação: 2017 Tipo de documento: Article