Occurrence of multidrug-resistant gram-negative bacteria from Hospital Sultan Abdul Aziz Shah wastewater and Kemensah River, Selangor, Malaysia

Ong, Xin Yi (2024) Occurrence of multidrug-resistant gram-negative bacteria from Hospital Sultan Abdul Aziz Shah wastewater and Kemensah River, Selangor, Malaysia. [Project Paper] (Submitted)

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Abstract

Introduction: Antibiotic is widely used especially in hospitals and runoff of water from point sources and non-point sources contaminate the river water. Antibiotic resistance that occurs across at least one agent in three or more antimicrobial classes is known as multidrug resistance (MDR). Objectives: This study aimed to determine the occurrence of multidrug-resistant (MDR) Gram-negative bacteria (GNB) from Hospital Sultan Abdul Aziz Shah (HSAAS) wastewater and Kemensah River, Selangor, Malaysia and to evaluate the type of antibiotics to which MDR GNB exhibits resistance. Methodology: About 250 mL of water samples were collected from the HSAAS sewage treatment plant (including grit chamber, aeration tank, clarifier tank, disinfection tank and v-notch) and Kemensah River (upstream). MacConkey agar, CHROMagar ESBL (extended-spectrum beta-lactamase) and CHROMagar mSuperCARBA were also used for bacteria isolation. Colonies’ growth on MacConkey agar was counted and isolated. Subcultures were performed and GNB were kept for stock culture and bacteria cultivation after Gram-staining and microscopic observation. Antimicrobial Susceptibility Testing was conducted with 13 types of antibiotics. Results and Discussion: There were six out of eight bacteria isolates from HSAAS wastewater and all three bacteria isolates from Kemensah River showed MDR phenotype. MDR GNB present in HSAAS wastewater were resistant to antibiotics namely amoxicillin-clavulanic acid/ amoxicillin-clavulanate (90%), ampicillin (75%), cefuroxime (75%), ceftriaxone (63%), ertapenem (63%), imipenem (75%), meropenem (50%), gentamicin (50%) and trimethoprim-sulfamethoxazole (63%) while for Kemensah River showed resistant to amoxicillin-clavulanic acid/ amoxicillin-clavulanate (100%), ampicillin (100%), cefuroxime (100%), ceftazidime (100%), ceftriaxone (100%), cefepime (100%), ertapenem (100%), imipenem (100%), meropenem (100%) and trimethoprim-sulfamethoxazole (100%). These show an association between the presence of MDR Gram-negative bacteria with the physicochemical properties in HSAAS wastewater and Kemensah River. Chlorine can be used to reduce but not fully eliminate the bacteria in HSAAS sewage treatment plant (STP). HSAAS wastewater had a higher temperature of 4-6.1 °C more than in Kemensah River, and the nitrate-nitrogen content exceeded the standard while Kemensah River had a higher reading of phosphorus and COD above the limit of standard limit. Conclusion: MDR GNB were found in both HSAAS wastewater and Kemensah River. Practical strategies must be implemented to improve the quality of the sewage from hospital wastewater treatment plants. Keywords: antibiotic, antibiotic resistance, multidrug-resistant, Gram-negative bacteria, water

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Ms Norafizah Radzuan
Date Deposited:	30 Apr 2025 02:26
Last Modified:	30 Apr 2025 02:26
URI:	http://psaspb.upm.edu.my/id/eprint/2398

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