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Hafiza Zirwa Noor
Fahim Ullah
Mahroona Afzal
Mahe E Noor Shamshad
Sarwat Moon
Qazi Sami Ul Haq
Hafiza Sehrish Kiani


Staphylococcus aureus, antibiotic resistance, hospital wastewater, community water supplies, Bannu


Background: Staphylococcus aureus (S. aureus) is a critical pathogen known for causing severe infections like bacteremia, endocarditis, and pneumonia. Hospitals, due to extensive antibiotic use, often become reservoirs for antibiotic-resistant bacteria, including S. aureus. This study examines the prevalence and resistance patterns of S. aureus in both hospital wastewater and community water supplies in Bannu, Pakistan.

Objectives: The primary objectives were to estimate the prevalence of S. aureus in the environment, characterize their antibiotic resistance patterns, and assess seasonal variations in their occurrence.

Methodology: From January to July 2020, samples were collected from hospital effluents and adjacent community tap water. These were processed to isolate S. aureus using selective media and confirmed via polymerase chain reaction (PCR). The isolates were then subjected to antibiotic susceptibility testing to determine resistance patterns.

Results: The study identified a high prevalence of S. aureus in community tap water, with 48.53% of samples testing positive, indicating significant environmental contamination. Among the isolates, there was an alarming resistance to Erythromycin (87.87%), Aztreonam (100%), and Cefixime (100%). Comparatively, isolates from hospital wastewater showed even higher resistance rates, particularly to multiple third-generation cephalosporins and macrolides. Interestingly, the study also documented seasonal fluctuations, with the highest occurrence of S. aureus in April, suggesting possible climatic or operational influences on bacterial proliferation. Additionally, resistance patterns varied between community and hospital sources, with hospital isolates generally exhibiting more extensive drug resistance, highlighting the impact of selective pressure from clinical antibiotic use.

Conclusion: The findings emphasize the pressing need for enhanced surveillance, improved wastewater management, and stringent antibiotic stewardship in hospital settings to mitigate the spread of antibiotic-resistant S. aureus. Public health interventions should also extend to community water systems to reduce exposure risks and safeguard community health.

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