article · World Journal of Advanced Pharmaceutical and Life Sciences
Clinical wastewater from a teaching hospital in Abakaliki, Nigeria, carries dangerous multidrug-resistant bacteria into the surrounding environment. Sampling across hospital effluent lines isolated forty strains of Escherichia coli, all displaying severe antibiotic resistance. Testing showed near-total resistance to common critical drugs, including aztreonam, ceftriaxone, nalidixic acid, and colistin, while gentamicin and ciprofloxacin remained the most active agents. Multiple antibiotic resistance scores across all isolates substantially exceeded established high-risk safety thresholds. Molecular testing revealed that every single isolated strain carried both blaTEM and blaNDM resistance genes, which confer extended-spectrum beta-lactamase and metallo-beta-lactamase activity. These findings demonstrate that untreated hospital wastewater serves as an active environmental reservoir for critical resistance genes, creating serious risks for the wider transmission of untreatable bacterial infections in community settings.
Hospital wastewater can act as a direct channel spreading superbugs into municipal environments and natural water sources. When bacteria acquire genes like blaNDM and blaTEM, standard antibiotics fail to cure common infections. Identifying these high-risk resistance genes helps public health authorities and hospital managers recognise the immediate danger posed by untreated clinical effluents to surrounding communities.
The findings highlight an urgent practical demand for on-site hospital wastewater treatment solutions, specialised effluent decontamination equipment, and environmental resistance surveillance diagnostics. Intended end-users include hospital facilities managers, municipal water authorities, and environmental monitoring agencies. However, the study represents early-stage surveillance research, and the abstract indicates no specific proprietary technology, product, or direct commercialisation pathway currently being developed from this work.
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Background: Hospital wastewater is increasingly recognized as a critical reservoir for multidrug-resistant Gram-negative bacteria, contributing to the global antimicrobial resistance crisis. Escherichia coli harboring extended-spectrum beta-lactamase (ESBL) and metallo-beta-lactamase (MBL) genes pose significant public health threats, particularly in resource-limited settings where wastewater treatment is inadequate. However, comprehensive data on the molecular characterization of these resistance determinants from clinical wastewater in southeastern Nigeria remain scarce. Objective: This study aimed to molecularly characterize ESBL (blaTEM) and MBL (blaNDM) genes in Escherichia coli isolated from clinical wastewater at Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria. Methods: A total of 30 effluent samples (500 mL each) were collected from clinical wastewater lines (CWL) of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Bacterial isolation and identification were performed using standard microbiological techniques. Antibiotic susceptibility testing was conducted using the Kirby-Bauer disk diffusion method, and Multiple Antibiotic Resistance (MAR) indices were calculated. Molecular characterization of blaTEM and blaNDM genes was performed by Polymerase Chain Reaction (PCR) using specific primers on all 40 isolated E. coli isolates. Results: E. coli was isolated from all sampling points, accounting for 40 (18.5%) of total bacterial isolates. All E. coli isolates exhibited high resistance to aztreonam (100%), ceftriaxone (97.5%), colistin (95.0%), and nalidixic acid (97.5%), while gentamicin (100%) and ciprofloxacin (87.5%) remained the most effective antibiotics. MAR indices ranged from 0.65 to 0.84, exceeding the 0.2 high-risk threshold. Molecular analysis revealed blaTEM and blaNDM genes in all 40 (100%) E. coli isolates, confirming the genetic basis for observed resistance patterns. Conclusion: This study provides the first molecular evidence of alarmingly high prevalence of E. coli co-harboring blaTEM and blaNDM genes in hospital wastewater from Abakaliki, Nigeria. The high MAR indices confirm hospital effluent as a high-risk source for antimicrobial resistance dissemination. These findings underscore the urgent need for on-site wastewater treatment interventions, enhanced antimicrobial stewardship, and integrated One Health surveillance to prevent environmental and community transmission of these multidrug-resistant pathogens.
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DOI: 10.53346/wjapls.2026.11.1.0017
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