PREVALENCE AND ANTIBIOTIC RESISTANCE PROFILES OF STAPHYLOCOCCUS AUREUS IN HOSPITAL WASTEWATER AND COMMUNITY DRINKING WATER SUPPLIES IN BANNU, PAKISTAN

Main Article Content

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

Keywords

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

Abstract

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.

Abstract 106 | Pdf Downloads 11

References

1. Mohr KI. History of antibiotics research. How to Overcome the Antibiotic Crisis: Facts, Challenges, Technologies and Future Perspectives. 2016:237-72.
2. Young HAK. Building the Good Fire Department; Practical Preparedness and Agenda Setting for Biological Weapons Release. 2015.
3. Komolafe O. Antibiotic resistance in bacteria-an emerging public health problem. Malawi medical journal. 2003;15(2):63-7.
4. Mutuku C, Gazdag Z, Melegh S. Occurrence of antibiotics and bacterial resistance genes in wastewater: resistance mechanisms and antimicrobial resistance control approaches. World Journal of Microbiology and Biotechnology. 2022;38(9):152.
5. Mitra S, Sultana SA, Prova SR, Uddin TM, Islam F, Das R, et al. Investigating forthcoming strategies to tackle deadly superbugs: current status and future vision. Expert Review of Anti-infective Therapy. 2022;20(10):1309-32.
6. Frank DN, Feazel LM, Bessesen MT, Price CS, Janoff EN, Pace NR. The human nasal microbiota and Staphylococcus aureus carriage. PloS one. 2010;5(5):e10598.
7. Kozajda A, Jeżak K, Kapsa A. Airborne Staphylococcus aureus in different environments—a review. Environmental Science and Pollution Research. 2019;26:34741-53.
8. Kaur R, Yadav B, Tyagi R. Microbiology of hospital wastewater. Current developments in Biotechnology and bioengineering: Elsevier; 2020. p. 103-48.
9. Nickerson EKF. Defining the burden of morbidity and mortality due to invasive Staphylococcus aureus disease and the impact of drug resistance in Thailand: Open University (United Kingdom); 2009.
10. David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clinical microbiology reviews. 2010;23(3):616-87.
11. Knox J, Uhlemann A-C, Lowy FD. Staphylococcus aureus infections: transmission within households and the community. Trends in microbiology. 2015;23(7):437-44.
12. Kumar A, Pal D. Antibiotic resistance and wastewater: Correlation, impact and critical human health challenges. Journal of environmental chemical engineering. 2018;6(1):52-8.
13. Liu Y, Li J, Zhou B, Li X, Chen H, Chen Q, et al. Efficient electricity production and simultaneously wastewater treatment via a high-performance photocatalytic fuel cell. Water research. 2011;45(13):3991-8.
14. Amin S. Prevalence of Bacteria in Drinking Water in Karachi andtheir Antimicrobial Susceptibility. Journal of the Dow University of Health Sciences (JDUHS). 2014;8(2):49-53.
15. Dewi RR, Hassan L, Daud HM, Matori MF, Nordin F, Ahmad NI, Zakaria Z. Prevalence and antimicrobial resistance of Escherichia coli, Salmonella and Vibrio derived from farm-raised Red Hybrid Tilapia (Oreochromis spp.) and Asian Sea Bass (Lates calcarifer, Bloch 1970) on the west coast of Peninsular Malaysia. Antibiotics. 2022;11(2):136.
16. Karimian M, Kermani R, Khaleghi M, Kelishadi R, Ataei B, Mostafavi N. Antibiotic susceptibility patterns of isolates from children with urinary tract infection in Isfahan, Iran: Impact on empirical treatment. Journal of global antimicrobial resistance. 2017;9:3-7.
17. Cai L, Sun J, Yao F, Yuan Y, Zeng M, Zhang Q, et al. Antimicrobial resistance bacteria and genes detected in hospital sewage provide valuable information in predicting clinical antimicrobial resistance. Science of The Total Environment. 2021;795:148815.
18. Shrivastava N, Sharma V, Nayak A, Shrivastava A, Sarkhel B, Shukla P, Shrivastava A. Prevalence and characterization of methicillin-resistant Staphylococcus aureus (MRSA) mastitis in dairy cattle in Jabalpur, Madhya Pradesh. Journal of Animal Research. 2017;7(1):77-84.