Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, Iran

Alisha Akya,1,2 Roya Chegenelorestani,1 Jila Shahvaisi-Zadeh,3 Arezoo Bozorgomid1 1Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Department of Microbiology, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Clinical R...

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Main Authors: Akya A, Chegenelorestani R, Shahvaisi-Zadeh J, Bozorgomid A
Format: Article
Language:English
Published: Dove Medical Press 2020-08-01
Series:Risk Management and Healthcare Policy
Subjects:
Online Access:https://www.dovepress.com/antimicrobial-resistance-of-staphylococcus-aureus-isolated-from-hospit-peer-reviewed-article-RMHP
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spelling doaj-46f228d22b7246218b029717de38c86f2020-11-25T03:56:12ZengDove Medical PressRisk Management and Healthcare Policy1179-15942020-08-01Volume 131035104255947Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, IranAkya AChegenelorestani RShahvaisi-Zadeh JBozorgomid AAlisha Akya,1,2 Roya Chegenelorestani,1 Jila Shahvaisi-Zadeh,3 Arezoo Bozorgomid1 1Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Department of Microbiology, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IranCorrespondence: Arezoo Bozorgomid Infectious Diseases Research CenterImam Reza Hospital, Daneshgah St., Shahid Shiroodi Blvd., Kermanshah 6715847141, IranTel +98-918 872 8269Email arezoobzorgomid@yahoo.comIntroduction: Hospital wastewater contains highly resistant and virulent bacteria that can spread into the environment. This study was conducted to investigate the antimicrobial resistance of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) in raw and treated hospital wastewater.Methods: During a three-month period, 40 sewage samples were collected from the hospital sewage (Kermanshah, Iran), and S. aureus were identified using culture and biochemical tests. MRSA was detected by resistance to cefoxitin. Antibiotic resistance (AR) was determined using disk diffusion according to the Clinical and Laboratory Standards Institute (CLSI) in 20 MSSA (10 raw and 10 treated sewage) and 40 MRSA isolates (20 raw and 20 treated sewage). The antimicrobial resistance genes (ARGs) were determined by PCR.Results: Eleven and eight percent of the isolates were MRSA in raw and treated sewage samples, respectively. Out of 60 isolates, 59 (98%) were multidrug resistant (MDR). The most common ARGs were mecA (raw=100%, treated=100%), aacA-D (raw=100%, treated=85%) and tetK (raw =95%, treated =45%) in MRSA, while the tetM gene was the most abundant gene (raw=50%, treated=80%) in MSSA. None of isolates (n=60) was positive for the vanB gene. MSSR (n=20) had the highest level of resistance against penicillin (100%), clindamycin (raw=90%, treated=90%), azithromycin (raw=80%, treated=90%). All MRSA isolates (n=40,100%) in both raw and treated sewage samples were non-susceptible to penicillin, oxacillin and azithromycin. There was no significant difference in the frequency AR and ARGs between raw and treated sewage samples (p> 0.05).Conclusion: The results indicated a high frequency of MDR and ARGs in both raw and treated sewage isolates which could be released into the environment through sewage system and pose a serious threat to public health. Hospital wastewater treatment processes should be improved in order to prevent the dissemination of the most resistant strains of S. aureus.Keywords: antibiotic resistance, antibiotic resistance genes, hospital wastewater, Staphylococcus aureushttps://www.dovepress.com/antimicrobial-resistance-of-staphylococcus-aureus-isolated-from-hospit-peer-reviewed-article-RMHPantibiotic resistanceantibiotic resistance geneshospital wastewaterstaphylococcus aureus.
collection DOAJ
language English
format Article
sources DOAJ
author Akya A
Chegenelorestani R
Shahvaisi-Zadeh J
Bozorgomid A
spellingShingle Akya A
Chegenelorestani R
Shahvaisi-Zadeh J
Bozorgomid A
Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, Iran
Risk Management and Healthcare Policy
antibiotic resistance
antibiotic resistance genes
hospital wastewater
staphylococcus aureus.
author_facet Akya A
Chegenelorestani R
Shahvaisi-Zadeh J
Bozorgomid A
author_sort Akya A
title Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, Iran
title_short Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, Iran
title_full Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, Iran
title_fullStr Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, Iran
title_full_unstemmed Antimicrobial Resistance of Staphylococcus aureus Isolated from Hospital Wastewater in Kermanshah, Iran
title_sort antimicrobial resistance of staphylococcus aureus isolated from hospital wastewater in kermanshah, iran
publisher Dove Medical Press
series Risk Management and Healthcare Policy
issn 1179-1594
publishDate 2020-08-01
description Alisha Akya,1,2 Roya Chegenelorestani,1 Jila Shahvaisi-Zadeh,3 Arezoo Bozorgomid1 1Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Department of Microbiology, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IranCorrespondence: Arezoo Bozorgomid Infectious Diseases Research CenterImam Reza Hospital, Daneshgah St., Shahid Shiroodi Blvd., Kermanshah 6715847141, IranTel +98-918 872 8269Email arezoobzorgomid@yahoo.comIntroduction: Hospital wastewater contains highly resistant and virulent bacteria that can spread into the environment. This study was conducted to investigate the antimicrobial resistance of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) in raw and treated hospital wastewater.Methods: During a three-month period, 40 sewage samples were collected from the hospital sewage (Kermanshah, Iran), and S. aureus were identified using culture and biochemical tests. MRSA was detected by resistance to cefoxitin. Antibiotic resistance (AR) was determined using disk diffusion according to the Clinical and Laboratory Standards Institute (CLSI) in 20 MSSA (10 raw and 10 treated sewage) and 40 MRSA isolates (20 raw and 20 treated sewage). The antimicrobial resistance genes (ARGs) were determined by PCR.Results: Eleven and eight percent of the isolates were MRSA in raw and treated sewage samples, respectively. Out of 60 isolates, 59 (98%) were multidrug resistant (MDR). The most common ARGs were mecA (raw=100%, treated=100%), aacA-D (raw=100%, treated=85%) and tetK (raw =95%, treated =45%) in MRSA, while the tetM gene was the most abundant gene (raw=50%, treated=80%) in MSSA. None of isolates (n=60) was positive for the vanB gene. MSSR (n=20) had the highest level of resistance against penicillin (100%), clindamycin (raw=90%, treated=90%), azithromycin (raw=80%, treated=90%). All MRSA isolates (n=40,100%) in both raw and treated sewage samples were non-susceptible to penicillin, oxacillin and azithromycin. There was no significant difference in the frequency AR and ARGs between raw and treated sewage samples (p> 0.05).Conclusion: The results indicated a high frequency of MDR and ARGs in both raw and treated sewage isolates which could be released into the environment through sewage system and pose a serious threat to public health. Hospital wastewater treatment processes should be improved in order to prevent the dissemination of the most resistant strains of S. aureus.Keywords: antibiotic resistance, antibiotic resistance genes, hospital wastewater, Staphylococcus aureus
topic antibiotic resistance
antibiotic resistance genes
hospital wastewater
staphylococcus aureus.
url https://www.dovepress.com/antimicrobial-resistance-of-staphylococcus-aureus-isolated-from-hospit-peer-reviewed-article-RMHP
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