Hospital Wastes as Potential Sources for Multi-Drug-Resistant ESBL-Producing Bacteria at a Tertiary Hospital in Ethiopia

• Main Authors: Mulatu Gashaw (Author), Esayas Kebede Gudina (Author), Wondwossen Tadesse (Author), Guenter Froeschl (Author), Solomon Ali (Author), Thomas Seeholzer (Author), Arne Kroidl (Author), Andreas Wieser (Author)
• Format: Book
• Published: MDPI AG, 2024-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/antibiotics13040374; 2079-6382
• Keywords: hospital waste; MDR; ESBL; NDM; CTX-M; Gram-negative bacteria; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 13, Iss 4, p 374 (2024)

The hospital environment is increasingly becoming an important reservoir for multi-drug-resistant (MDR) Gram-negative bacteria, posing serious challenges to efforts to combat antimicrobial resistance (AMR). This study aimed to investigate the role of hospital waste as a potential source of MDR ESBL-producing bacteria. Samples were collected from multiple sources within a hospital and its vicinity, including surface swabs, houseflies, and sewage samples. The samples were subsequently processed in a microbiology laboratory to identify potential pathogenic bacteria and confirmed using MALDI-TOF MS. Bacteria were isolated from 87% of samples, with the predominant isolates being <i>E. coli</i> (30.5%), <i>Klebsiella</i> spp. (12.4%), <i>Providencia</i> spp. (12.4%), and <i>Proteus</i> spp. (11.9%). According to the double disc synergy test (DDST) analysis, nearly half (49.2%) of the bacteria were identified as ESBL producers. However, despite exhibiting complete resistance to beta-lactam antibiotics, 11.8% of them did not test positive for ESBL production. The characterization of <i>E. coli</i> revealed that 30.6% and 5.6% of them carried <i>bla</i>CTX-M group 1 type-15 and <i>bla</i>NDM genes, respectively. This finding emphasizes the importance of proper hospital sanitation and waste management practices to mitigate the spread of AMR within the healthcare setting and safeguard the health of both patients and the wider community.