title: Detection of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in effluents and sludge of a hospital sewage treatment plant.
abstract: OBJECTIVE
  To detect ESBL (extended-spectrum beta-lactamase)-producing Klebsiella pneumoniae present in the effluents and sludge of a hospital sewage treatment plant, evaluating the treatment plant's potential to remove these micro-organisms.
  
  
  RESULTS
  Twenty samples (crude sewage, UASB reactor effluent, filtered effluent and sludge) were collected in the period from May to December 2006, in order to analyse antimicrobial susceptibility and to check ESBL production, the disc-diffusion and the combined disc methods were used. Total and faecal coliform concentrations were also determined. ESBL-producing K. pneumoniae were detected in all samples analysed, representing 46 x 5% of the total strains isolated. Among the non-ESBL-producing strains, 26% were multiresistant and one strain resistant to eight of the nine antimicrobials tested was detected in the treated effluent.
  
  
  CONCLUSIONS
  The hospital wastewater treatment plant did not show a satisfactory efficacy in removing pathogenic micro-organisms, allowing for the dissemination of multiresistant bacteria into the environment.
  
  
  CONCLUSIONS
  The inefficacy of hospital wastewater treatment plants can result in routes of dissemination of multiresistant bacteria and their genes of resistance into the environment, thus contaminating water resources, and having serious negative impact on public health.
authors.affiliation: Department of Sanitation and Environmental Health - Public Health National School, Oswaldo Cruz Foundation - Rio de Janeiro (RJ), Brazil.
authors.forename: T
authors.initials: T
authors.lastname: Prado
authors.forename: W C
authors.initials: WC
authors.lastname: Pereira
authors.forename: D M
authors.initials: DM
authors.lastname: Silva
authors.forename: L M
authors.initials: LM
authors.lastname: Seki
authors.forename: A P D'A
authors.initials: AP
authors.lastname: Carvalho
authors.forename: M D
authors.initials: MD
authors.lastname: Asensi
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil; D002440:Cefoxitin / Q000494:pharmacology; D002442:Ceftazidime / Q000494:pharmacology; D019818:Clavulanic Acid / Q000494:pharmacology; D006272:Health Facility Environment; D006761:Hospitals / Q000592:standards*; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000302:isolation & purification; D017744:Medical Waste Disposal / Q000379:methods / Q000592:standards*; D008826:Microbial Sensitivity Tests; D012722:Sewage / Q000382:microbiology*; D018440:beta-Lactam Resistance / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D017744:Medical Waste Disposal; D012722:Sewage; D019818:Clavulanic Acid; D002440:Cefoxitin; D002442:Ceftazidime