Occurrence and Anti-microbial Susceptibility Pattern of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae in Governmental Hospital Wastewater in Addis Ababa, Ethiopia
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Date
2021-06
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Addis Abeba University
Abstract
Background: Worldwide, come out and dissemination of Extended-spectrum beta-lactamases
(ESBLs) producing Enterobacteriaceae has been warning the efficacy of antibiotics to treat an
infection. Hospital wastewater might be a reservoir of such kind of resistant bacteria. Currently,
the predominant antibiotics used for the treatment of hospitalized patients infected by Gram
negative bacteria are the 𝛽-lactam antibiotics. So it is an important source to investigate the
magnitude of ESBLs producing bacteria and their antimicrobial susceptibility pattern.
Objective:-To determine the occurrence of ESBLs producing Enterobacteriaceae(ESBLs-pE).
and their antibiotic susceptibility pattern in wastewater released from governmental hospitals in
Addis Ababa, Ethiopia.
Method: Across-sectional study was carried out from April 1 to May 31, 2020. A total of 100
wastewaters were collected from five governmental hospitals in Addis Ababa using a grapsampling
technique. All Enterobacteriaceae were screened for ESBLs production using
cefotaxime and ceftazidime as per 29
th
CLSI guideline. Each screen positive for ESBLs
production was confirmed by the combination disk method (CDT) and their antibiotic
susceptibility pattern were done using the Kirby-Bauer disk diffusion method on Muller Hinton
agar (MHA). Data were entered and summarized using SPSS version 20 software.
Results: Of all Enterobacteriaceae, 48.3% were confirmed ESBLs-pE. The highest ratio of
ESBLs-Pe was observed in adult ward (66.7%) and laundry unit effluent (58.8%). The highest
ESBL producers were E. coli (21.8%) and K. pneumoniae (4.8%). The most elevated resistance
level of ESBL producer were observed to cefotaxime (95.8%) and amoxacilline/clavunalate
(93%). 64% of tested Enterobacteriaceae isolates were multi drug resistant (MDR).
Conclusion: Higher magnitude of MDR and ESBLs-pE were present in the hospital wastewater.
Majority of them were in adult ward and laundry unit effluents. The most frequent ESBLs-pE
was among E .coli and K. pneumoniae. Hence, Consistent infection prevention and control
procedures should be in practice at each ward/unit.
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Keywords
Hospital, Wastewater, Beta Lactamase, ESBLs, Enterobacteriacea, Multi-drug resistance