title: Multidrug resistant Pseudomonas aeruginosa survey in a stream receiving effluents from ineffective wastewater hospital plants.
abstract: Multi-drug resistant forms of Pseudomonas aeruginosa (MDRPA) are a major source of nosocomial infections and when discharged into streams and rivers from hospital wastewater treatment plants (HWWTP) they are known to be able to persist for extended periods. In the city of Manaus (Western Brazilian Amazon), the effluent of three HWWTPs feed into the urban Mindu stream which crosses the city from its rainforest source before draining into the Rio Negro. The stream is routinely used by Manaus residents for bathing and cleaning (of clothes as well as domestic utensils) and, during periods of flooding, can contaminate wells used for drinking water.
  
  
  
  16S rRNA metagenomic sequence analysis of 293 cloned PCR fragments, detected an abundance of Pseudomonas aeruginosa (P. aeruginosa) at the stream's Rio Negro drainage site, but failed to detect it at the stream's source. An array of antimicrobial resistance profiles and resistance to all 14 tested antimicrobials was detected among P. aeruginosa cultures prepared from wastewater samples taken from water entering and being discharged from a Manaus HWWTP. Just one P. aeruginosa antimicrobial resistance profile, however, was detected from cultures made from Mindu stream isolates. Comparisons made between P. aeruginosa isolates' genomic DNA restriction enzyme digest fingerprints, failed to determine if any of the P. aeruginosa found in the Mindu stream were of HWWTP origin, but suggested that Mindu stream P. aeruginosa are from diverse origins. Culturing experiments also showed that P. aeruginosa biofilm formation and the extent of biofilm formation produced were both significantly higher in multi drug resistant forms of P. aeruginosa.
  
  
  
  Our results show that a diverse range of MDRPA are being discharged in an urban stream from a HWWTP in Manaus and that P. aeruginosa strains with ampicillin and amikacin can persist well within it.
authors: Programa de Pós-Graduação Sociedade e Endemias na Amazônia, ILMD, 476, Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.
authors: Mary Joyce Targino Lopes
authors: MJ
authors: Magalhães
authors: Instituto Nacional de Pesquisa da Amazônia - INPA, 2936 André Araújo Av, 69060-001, Manaus, AM, Brazil.
authors: Gemilson
authors: G
authors: Pontes
authors: Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.
authors: Paula Takita
authors: PT
authors: Serra
authors: Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.
authors: Antonio
authors: A
authors: Balieiro
authors: Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.
authors: Diogo
authors: D
authors: Castro
authors: Departamento Básico - Área de Saúde; Campus Governador Valadares, Universidade Federal de Juiz de Fora, Rua Israel Pinheiro, 2000, Bairro Universitário, Governador Valadares, MG, Brazil.
authors: Fabio Alessandro
authors: FA
authors: Pieri
authors: Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.
authors: James Lee
authors: JL
authors: Crainey
authors: Programa de Pós-Graduação Sociedade e Endemias na Amazônia, ILMD, 476, Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.|Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.
authors: Paulo Afonso
authors: PA
authors: Nogueira
authors: Programa de Pós-Graduação Sociedade e Endemias na Amazônia, ILMD, 476, Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil. patricia_orlandi@amazonia.fiocruz.br.|Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil. patricia_orlandi@amazonia.fiocruz.br.
authors: Patricia Puccinelli
authors: PP
authors: Orlandi
mesh_terms: D000583:Amikacin / Q000494:pharmacology; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D044822:Biodiversity; D018441:Biofilms; D001938:Brazil; D016172:DNA Fingerprinting; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D006761:Hospitals; D008826:Microbial Sensitivity Tests; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification* / Q000502:physiology; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D045483:Rivers / Q000382:microbiology*; D062065:Wastewater / Q000382:microbiology*
chemical_list: D000583:Amikacin; D000667:Ampicillin; D000900:Anti-Bacterial Agents; D012336:RNA, Ribosomal, 16S; D062065:Wastewater
keywords: 16S-rRNA gene; Amazon; Contamination; Hospital effluent; PFGE; Pseudomonas aeruginosa