Alta frecuencia de bacilos Gram negativos de importancia clínica resistentes a betalactámicos en efluentes de aguas residuales hospitalarias

Abstract

Introduction: Bacterial resistance is a multifactorial phenomenon, where scenarios other than the hospital setting have gained significant importance. Objective: To determine the presence of beta-lactam-resistant Gram-negative bacilli of clinical importance in wastewater from a highly complex hospital in Me-dellín, Antioquia.Materials and methods: A descriptive cross-sectional study was carried out. Two wastewater samples were taken from two effluents from a highly complex hospital between November and December 2018. Bacteria were isolated from chromogenic agar, and subsequently, molecular PCR characterization of beta-lactamases of clinical importance was performed. Bacterial identification and susceptibility were determinate by automatized method.Results:Ninety isolates from hospital effluents were obtained, of which 78.90% (n=71) had at least one gene that encoded for ESBL or penicillinase; and 78.90% (n=71) at least one gene coding for carbapenemases. Citrobacter freundii was the predominant bacteria in the evaluated isolates (30% n=12), followed by Klebsiella pneumoniae (25% n=10). In the isolates selected for susceptibility determination, all (100% n=40) were found to have multidrug resistance (MDR).Conclusion: The high presence of bacteria resistant to beta-lactams in wastewater from hospital, evidences the need to implement management strategies for these wastes, given the potential risk for the transmission and spread of resistant bacteria.

Keywords

• bacterial resistance
• gram negative bacilli
• hospital wastewater
• betalactamases