title: Detection of carbapenem resistance genes and cephalosporin, and quinolone resistance genes along with oqxAB gene in Escherichia coli in hospital wastewater: a matter of concern.
abstract: OBJECTIVE
  This study was performed to detect the presence of Escherichia coli resistant to cephalosporins, carbapenems and quinolones in hospital wastewater.
  
  
  RESULTS
  Wastewaters from a rural (H1) and an urban (H2) hospital were tested for E. coli resistant to cephalosporins, carbapenem and quinolones. Genes coding for chromosomal and plasmid-mediated resistance and phylogenetic grouping was detected by multiplex polymerase chain reaction (PCR) and for genetic relatedness by rep-PCR. Of 190 (H1 = 94; H2 = 96) E. coli examined, 44% were resistant to both cephalosporins and quinolones and 3% to imipenem. ESBLs were detected phenotypically in 96% of the isolates, the gene blaCTX-M coding for 87% and blaTEM for 63%. Quinolone resistance was due to mutations in gyrA and parC genes in 97% and plasmid-coded aac-(6')-Ib-cr in 89% of isolates. Only in one carbapenem-resistant E. coli, NDM-1 was detected. Nearly 67% of the isolates belonged to phylogenetic group B2. There was no genetic relatedness among the isolates.
  
  
  CONCLUSIONS
  Hospital wastewater contains genetically diverse multidrug-resistant E. coli.
  
  
  CONCLUSIONS
  This study stresses the need for efficient water treatment plants in healthcare settings as a public health measure to minimize spread of multidrug-resistant bacteria into the environment.
authors: Division of Infectious Diseases, St. John's Research Institute, Bangalore, India; Department of Microbiology, St. John's Medical College, Bangalore, India.
authors: S P
authors: SP
authors: Chandran
authors: V
authors: V
authors: Diwan
authors: A J
authors: AJ
authors: Tamhankar
authors: B V
authors: BV
authors: Joseph
authors: S
authors: S
authors: Rosales-Klintz
authors: S
authors: S
authors: Mundayoor
authors: C S
authors: CS
authors: Lundborg
authors: R
authors: R
authors: Macaden
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D002511:Cephalosporins / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics*; D004927:Escherichia coli Infections / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000235:genetics; D008969:Molecular Sequence Data; D010802:Phylogeny; D015363:Quinolones / Q000494:pharmacology*; D062065:Wastewater / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D029968:Escherichia coli Proteins; D015363:Quinolones; D062065:Wastewater
keywords: carbapenem resistance; cephalosporin resistance; hospital wastewater; multidrug-resistant E. coli; quinolones resistance