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A study of prevalence of pathogenic bacteria, particularly, fecal coliforms and their antibiotic resistance pattern in environmental water samples of a tertiary-care hospital, Ahmedabad

Nidhi K Sood, Parul C Patel, Sachin M Patel, Asha H Mandalia.


Background: The spread of antibiotic resistance in environmental bacteria is a known phenomenon. Escherichia coli are a part of the normal flora of human and animal fecal matters, which may contaminate the soil and water. By far, no study is done in our region to know the prevalence of antibiotic resistance in environmental bacteria.

Objective: To know the prevalence of pathogenic bacteria, particularly, fecal coliforms along with their antibiotic resistance profile in environmental water body in our hospital.

Materials and Methods: Fifty water samples consisting of drinking water, water from the drainage pipes, and water from the leaking pipes of General Hospital, Sola, Ahmedabad, India, were studied for the determination of the prevalence of antibiotic-resistant coliforms. Water samples were collected for analysis of fecal contamination and to detect the most probable number (MPN) of fecal coliforms by multiple-tube fermentation technique. Antibiotic resistance of the E. coli isolates and Klebsiella were determined by Kirby–Bauer disc diffusion method using Clinical and Laboratory Standards Institute (CLSI) guidelines.

Result: Of the 50 samples collected from the civil hospital, 22 samples (44%) showed contamination with fecal coliform. Of the 22 positive samples, E. coli was isolated from 12 water samples; Klebsiella was isolated from 10 samples. Majority of the isolates from the drinking water were sensitive to cotrimoxazole, quinolones, chloramphenicol, aminoglycosides, third-generation cephalosporins, and tetracyclins. However, all the E. coli isolated from drainage water were resistant to cotrimoxazole, third-generation cephalosporins, and gentamicin. About 50% isolates from the drainage supplies showed resistance to quinolones and tetracyclins. Isolates from tap water and leaking pipe lines were sensitive to majority of the drugs.

Conclusion: A comparison of isolates from drinking water with drainage water revealed that antibiotic resistance is widespread in environmental bacteria. A very higher proportion of antibiotic resistance in drainage water isolates can be correlated with an extensive and sometimes over use of antibiotics, along with the use of higher antibiotics only, even for the treatment of mild infections in patients and spillage of resistant bacteria from patients to the environment. Resistance to higher antibiotics such as third-generation cephalosporins and aminoglycosides, which are hope for severe infections is alarming, as the replacement of sensitive bacterial flora with resistant florae will invite serious infections and difficult treatment situations. This study alarms for an appropriate and judicious antibiotic usage.

Key words: Antibiotic-resistant bacteria, environmental bacteria, thermotolerant E. coli

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