Occurrence of multidrug resistant and extended spectrum β-lactamase (ESBL) - producing Escherichia coli in wastewater of two healthcare facilities in Ibadan, Nigeria

Most industries in developing countries of the world, especially hospitals and other clinical settings, lack wastewater treatment facilities, and as such, untreated wastewater from their operations are discharged into water bodies without any form of treatment. This study aimed at the antibiotic sensitivity profile and ESBL production in E. coli isolated from untreated hospital wastewater before discharge into the environment. Untreated wastewater from two hospitals, a State Government-owned hospital (SGH) and a privately-owned hospital (POH) with no wastewater treatment facilities were sampled for a period of four months. Isolation of E. coli was carried out using the pour plate technique on Eosin Methylene Blue agar, while identification was carried out using conventional methods. Determination of ESBL production was done by means of the Double Disc Synergy Technique and antibiotic sensitivity testing was carried out by employing the disc diffusion method. A total of fifty-eight (58) E. coli were obtained: SGH at 55 and POH at 3. Herein, in 100% of the total count, resistance was indicated for ampicillin and ertapenem, while 14%, 11%, 16% and 57% of the total count were resistant to ceftazidime, cefpodoxime, cefotaxime and amoxicillin-clavulanate, respectively. In addition, 94.8% showed resistance to tetracycline, 19% to ciprofloxacin, 6.9% to gentamycin, 39.7% to chloramphenicol and 55% and 47% to sulfamethoxazole-trimethoprim and nalidixic acid, respectively. Furthermore, 94.8% of all the isolates were multidrug resistant (MDR), while 29.3% were ESBL positive. Wastewater from the two hospitals under study contained ESBL positive and MDR E. coli, suggesting a need to forestall a potential threat to public health by treating the wastewater generated by both hospitals before discharge into the environment