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Lookup NU author(s): Manisha Lamba, Professor David GrahamORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
Increasing antibiotic resistant hospital-acquired infections and limited new antibiotic discovery are jeopardizing human health at global scales, although how hospitals themselves fuel AMR in the wider environment is largely unknown. Antibiotic resistance (AR) from hospitals in countries like India is potentially problematic because of high antibiotic use, overcrowding, and inadequate wastewater containment. Here we quantified fecal coliforms (FC), carbapenem-resistant Enterobacteriaceae (CRE), blaNDM-1, and selected extended-spectrum β-lactam (ESBL) resistant bacteria and genes in 12 hospital wastewater outfalls and five background sewer drains across New Delhi over two seasons. Hospital wastewaters had up to nine orders of magnitude greater concentrations of CRE bacteria and blaNDM-1 than local sewers (depending on the hospital), implying hospitals contribute high concentrations of AR relative to community sources in Delhi, especially during the winter. Significant correlations were found between FC levels (a fecal indictor), and CRE (r =0.924; p =0.005), blaNDM-1 (r=0.934, p=0.009), and ESBL-resistant bacteria (r=0.913, p=0.010) levels across hospital wastewaters, respectively, imp-lying elevated CRE and blaNDM-1 are of patient origin. However, of greater importance to global health, microbial culturing found 18 to 41% of wastewater CRE isolates (n =1447) were on the WHO “critical pathogen” list in urgent need of new antibiotics, and 55% of CRE isolates from larger hospitals carried at least one blaNDM-1 gene. Wastewater releases from New Delhi hospitals may pose a greater AR exposure risk to residents than believed, implying in-hospital antibiotic use must be better controlled and more effective waste treatment is needed for hospital wastewaters.
Author(s): Lamba M, Graham DW, Ahammad SZ
Publication type: Article
Publication status: Published
Journal: Environmental Science & Technology
Year: 2017
Volume: 51
Issue: 23
Pages: 13906–13912
Print publication date: 05/12/2017
Online publication date: 26/09/2017
Acceptance date: 26/09/2017
Date deposited: 14/10/2017
ISSN (print): 0013-936X
ISSN (electronic): 1520-5851
Publisher: American Chemical Society
URL: https://doi.org/10.1021/acs.est.7b03380
DOI: 10.1021/acs.est.7b03380
Data Access Statement: http://dx.doi.org/10.17634/149412-1
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