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Int. J. Environ. Res. Public Health 2017, 14(7), 699; https://doi.org/10.3390/ijerph14070699

Antibiotic Resistance and Antibiotic Resistance Genes in Escherichia coli Isolates from Hospital Wastewater in Vietnam

1
Health Systems and Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 17177 Stockholm, Sweden
2
Department of Pharmaceutical Management and Pharmaco-Economics, Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hoan Kiem District, Hanoi 110403, Vietnam
3
Department of Dermatology and Venereology, Department of Family Medicine, Department of Microbiology, Hanoi Medical University, 01 Ton That Tung, Dong Da District, Hanoi 116516, Vietnam
4
National Centralized Drug Procurement Centre, Vietnam Ministry of Health, 138A Giang Vo Street, Ba Dinh district, Hanoi 118401, Vietnam
5
Department of Microbiology, Bach Mai Hospital, 78 Giai Phong, Dong Da District, Hanoi 116365, Vietnam
6
Department of Public Health & Environment, R.D. Gardi Medical College, Agar Road, Ujjain 456006, India
7
Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Agar Road, Ujjain 456006, India
*
Author to whom correspondence should be addressed.
Received: 24 April 2017 / Revised: 29 May 2017 / Accepted: 23 June 2017 / Published: 29 June 2017
(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)
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Abstract

The environmental spread of antibiotic-resistant bacteria has been recognised as a growing public health threat for which hospitals play a significant role. The aims of this study were to investigate the prevalence of antibiotic resistance and antibiotic resistance genes (ARGs) in Escherichia coli isolates from hospital wastewater in Vietnam. Wastewater samples before and after treatment were collected using continuous sampling every month over a year. Standard disk diffusion and E-test were used for antibiotic susceptibility testing. Extended-spectrum beta-lactamase (ESBL) production was tested using combined disk diffusion. ARGs were detected by polymerase chain reactions. Resistance to at least one antibiotic was detected in 83% of isolates; multidrug resistance was found in 32%. The highest resistance prevalence was found for co-trimoxazole (70%) and the lowest for imipenem (1%). Forty-three percent of isolates were ESBL-producing, with the blaTEM gene being more common than blaCTX-M. Co-harbouring of the blaCTX-M, blaTEM and qepA genes was found in 46% of isolates resistant to ciprofloxacin. The large presence of antibiotic-resistant E. coli isolates combined with ARGs in hospital wastewater, even post-treatment, poses a threat to public health. It highlights the need to develop effective processes for hospital wastewater treatment plants to eliminate antibiotic resistant bacteria and ARGs. View Full-Text
Keywords: antibiotic resistance; antibiotic resistance genes; blaCTX-M; blaTEM; qepA; hospital wastewater antibiotic resistance; antibiotic resistance genes; blaCTX-M; blaTEM; qepA; hospital wastewater
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Lien, L.T.Q.; Lan, P.T.; Chuc, N.T.K.; Hoa, N.Q.; Nhung, P.H.; Thoa, N.T.M.; Diwan, V.; Tamhankar, A.J.; Stålsby Lundborg, C. Antibiotic Resistance and Antibiotic Resistance Genes in Escherichia coli Isolates from Hospital Wastewater in Vietnam. Int. J. Environ. Res. Public Health 2017, 14, 699.

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