title: Multiresistance, beta-lactamase-encoding genes and bacterial diversity in hospital wastewater in Rio de Janeiro, Brazil.
abstract: OBJECTIVE
  To investigate the bacterial diversity, antimicrobial resistance patterns and types of beta-lactamase genes in Gram-negative bacteria isolated from a hospital sewage treatment plant.
  
  
  RESULTS
  Between July and December 2008, we collected samples from influent, clarifier tank effluent and chlorine contact tank effluent from a sewage treatment plant service of a hospital located in the city of Rio de Janeiro, Brazil. Of the 221 isolates identified, 40% were characterized as extended-spectrum beta-lactamase (ESBL) producers. Nonpathogenic micro-organisms and some pathogenic genera were quantified. The most common ESBL-producing isolates were Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli. The bla(TEM), bla(SHV) and bla(CTX-M) genes were detected in 82, 48 and 67% of bacterial isolates, respectively.
  
  
  CONCLUSIONS
  Results showed that hospital wastewater treatment plant is not suitable systems for the removal of all antibiotic-resistant micro-organisms present in hospital wastewaters.
  
  
  CONCLUSIONS
  This study provides evidence that bacteria resistant to multiple antibiotics and their resistance genes that are usually present in the hospital can reach the environment, even after the use of hospital wastewater treatment plants.
authors.affiliation: Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
authors.forename: T P G
authors.initials: TP
authors.lastname: Chagas
authors.forename: L M
authors.initials: LM
authors.lastname: Seki
authors.forename: J C
authors.initials: JC
authors.lastname: Cury
authors.forename: J A L
authors.initials: JA
authors.lastname: Oliveira
authors.forename: A M R
authors.initials: AM
authors.lastname: Dávila
authors.forename: D M
authors.initials: DM
authors.lastname: Silva
authors.forename: M D
authors.initials: MD
authors.lastname: Asensi
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D044822:Biodiversity; D001938:Brazil; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016972:Enterobacter cloacae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D006761:Hospitals; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010802:Phylogeny; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012722:Sewage / Q000382:microbiology*; D014865:Waste Disposal, Fluid; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S; D012722:Sewage; D001618:beta-Lactamases