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Updated: Jun 5, 2026
Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
Multiple drug resistance in bacterial isolates from liquid wastes generated in central hospitals of Nepal
D R Sharma1, B Pradhan, S K Mishra
1Department of Public Health, Yeti Health Science Academy, Kathmandu, Nepal. dsharmadr@hotmail.com
Background:
Healthcare liquid wastes are the reservoirs of harmful infectious agents such as the pathogens and multiple drug resistant microorganisms. Potential infectious risks include the spread of infectious diseases and microbial resistance from health-care establishments into the environment and thereby posing risks of getting infections and antibiotic resistance in the communities.
Objectives:
The objectives of this study were to assess the bacterial load of healthcare liquid waste generated in central hospitals and to explore the antimicrobial resistance pattern of these bacterial isolates.
Materials And Methods:
A descriptive study was carried out in 10 conveniently selected central hospitals of Nepal during the period of May to December 2008. Effluent specimens from each hospital were subjected to total viable count studies by spread plate method in nutrient agar plate and incubated for 24 hours at 37 °C using standard laboratory protocol. Similarly, all the specimens were cultured in Mac Conkey Agar media supplemented with 30 μg/ml of Chloramphenicol and 20 μg/ml of Gentamycin for the enumeration of multiple drug resistant (MDR) bacteria, which were further subjected to in-vitro antibiotic susceptibility test by modified Kirby Bauer disc diffusion technique for resistance patterns.
Results:
Total viable counts of hospital effluents significantly exceeded the standard heterotrophic plate count (p=0.000). Similarly, the numbers of multiple drug resistant bacteria were alarmingly high in three (more than 30% in 2 and 50% in 1) hospitals of this study. Drug resistant hospital effluent isolates showed simultaneous resistance for most of the antibiotics including Penicillin, Cephalosporin, Cotrimoxazole, Gentamycin and Quinolones.
Conclusion:
Healthcare liquid wastes were laden with MDR bacteria and seemed to pose a huge public health threat in the transfer of such resistance to the bacterial pathogens causing community acquired infections, thereby limiting our antibiotic pool.
Insights
Healthcare liquid waste harbors dangerous bacteria, posing a significant public health risk. This study found high levels of antibiotic-resistant bacteria in hospital wastewater, contributing to the spread of antimicrobial resistance in communities.
Area of Science:
- Environmental microbiology
- Public health
- Infectious diseases
Background:
- Healthcare liquid waste acts as a reservoir for pathogens and multidrug-resistant microorganisms.
- Infectious risks include the environmental spread of diseases and microbial resistance from healthcare facilities.
Purpose of the Study:
- To assess bacterial load in healthcare liquid waste from central hospitals in Nepal.
- To investigate the antimicrobial resistance patterns of bacterial isolates from this waste.
Main Methods:
- A descriptive study was conducted in 10 central hospitals in Nepal.
- Bacterial load was determined using total viable count and spread plate method.
- Multiple drug-resistant (MDR) bacteria were enumerated and their antibiotic susceptibility tested using the Kirby Bauer disc diffusion technique.
Main Results:
- Hospital effluent bacterial counts significantly exceeded standard heterotrophic plate counts.
- Alarmingly high numbers of MDR bacteria were found in effluents from three hospitals.
- Resistant isolates exhibited simultaneous resistance to multiple antibiotics, including Penicillin, Cephalosporin, Cotrimoxazole, Gentamycin, and Quinolones.
Conclusions:
- Healthcare liquid waste is heavily contaminated with MDR bacteria.
- This contamination poses a substantial public health threat by facilitating the transfer of resistance to community-acquired pathogens.
- The findings highlight a significant limitation on the effectiveness of our antibiotic arsenal.
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