Publication: Multiple drug resistance in bacterial isolates from liquid wastes generated in central hospitals of Nepal
Date
2010
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: Healthcare liquid wastes are the reservoirs of harmful infectious agents such as the pathogens and
multiple drug resistant microorganisms. Potential infectious risks include the spread of infectious diseases and microbial
resistance from health-care establishments into the environment and thereby posing risks of getting infections and
antibiotic resistance in the communities.
Objectives: The objectives of this study were to assess the bacterial load of healthcare liquid waste generated in central
hospitals and to explore the antimicrobial resistance pattern of these bacterial isolates.
Materials and methods: A descriptive study was carried out in 10 conveniently selected central hospitals of Nepal
during the period of May to December 2008. Effluent specimens from each hospital were subjected to total viable
count studies by spread plate method in nutrient agar plate and incubated for 24 hours at 370C using standard laboratory
protocol. Similarly, all the specimens were cultured in Mac Conkey Agar media supplemented with 30 μg/ml of
Chloramphenicol and 20 μg/ml of Gentamycin for the enumeration of multiple drug resistant (MDR) bacteria, which
were further subjected to in-vitro antibiotic susceptibility test by modified Kirby Bauer disc diffusion technique for
resistance patterns.
Results: Total viable counts of hospital effluents significantly exceeded the standard heterotrophic plate count (p=0.000).
Similarly, the numbers of multiple drug resistant bacteria were alarmingly high in three (more than 30% in 2 and 50%
in 1) hospitals of this study. Drug resistant hospital effluent isolates showed simultaneous resistance for most of the
antibiotics including Penicillin, Cephalosporin, Cotrimoxazole, Gentamycin and Quinolones.
Conclusion: Healthcare liquid wastes were laden with MDR bacteria and seemed to pose a huge public health threat in
the transfer of such resistance to the bacterial pathogens causing community acquired infections, thereby limiting our
antibiotic pool.
Key words: Healthcare liquid waste management, viable count, multiple drug resistance, hospitals, Nepal
Description
Sharma DR 1, Pradhan B 2, Mishra SK3
1Lecturer, Department of Public Health, Yeti Health Science Academy, Kathmandu, Nepal, 2Associate Professor, Department of Community Medicine and Family Health, Institute of Medicine, Kathmandu Nepal, 3Assistant Professor, Department of Clinical Biochemistry, Kantipur Dental College, Kathmandu, Nepal.