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Hospital liquid waste contaminated with multidrug-resistant bacteria raises a public health hazard alert in Brazil

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Abstract

The spread of multidrug-resistant bacteria (MDR) is a global concern because it poses a serious threat to public health. The inadequate handling of Health Services Waste (HSW) and, therefore, the incorrect disposal of infected liquids can cause contamination of the environment, the emergence of diseases caused by MDR bacteria, and the loss of the population's quality of life. The present study aimed to survey the bacteria and their antimicrobial resistance profiles, present in the liquid residues from infected surgeries performed in five years, often discharged into the sewage network of a large tertiary hospital located in the city of Uberlândia, which is considered one of the main economic and demographic centers of Brazil. A systematic and retrospective survey of the medical records of patients who underwent infected surgeries from January 2015 to December 2019 was carried out at the referred hospital. The bacterial species were previously identified and characterized for the antimicrobial susceptibility profile by the VITEK 2 automated system (bioMérieux, Brazil). In the evaluated period, 1658 infected surgeries were performed and the results showed 661 bacterial strains distributed in 48 different species, being Staphylococcus aureus the most prevalent species. The vast majority (85.6%) showed some type of antimicrobial resistance among these strains, with more than half (54.6%) being MDR. The results of this work raise an alert and concern for the risks to the environment and public health by dumping these infected liquid wastes directly into the sewage system without proper prior decontamination.

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Acknowledgements

We are thankful to thank Edner Silva Torres (Uberlandia, MG, Brazil) for the English revision.

Funding

This work was supported by the São Paulo State Research Support Foundation (FAPESP) (Grant no. 2013/22581–5). RN-S is a Ph.D. fellow of Higher Education Personnel Improvement Coordination (CAPES); therefore, this study was financed in part by the CAPES (grant no 88882365161 and Finance Code 001).

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Authors and Affiliations

  1. Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto – UNAERP., Av. Costábile Romano, 2201, São Paulo, 14096-900, Ribeirão Preto, Brazil

    Leila Lúcia Dias, Rafael Nakamura-Silva & André Pitondo-Silva

  2. Faculdade de Medicina, Universidade Federal de Uberlândia, Av. Pará, 1720, Minas Gerais, 38400-902, Uberlândia, Brazil

    Leila Lúcia Dias, Gilberto André Teles de Oliveira Junior, Ivan Orlando Gonzales Mego & Guilherme Silva Mendonça

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  1. Leila Lúcia Dias
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  2. Rafael Nakamura-Silva
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  3. Gilberto André Teles de Oliveira Junior
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  4. Ivan Orlando Gonzales Mego
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  5. Guilherme Silva Mendonça
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  6. André Pitondo-Silva
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Contributions

Leila L. Dias: conceived and designed the study, formal analysis, investigation and writing; Gilberto A. T. Oliveira Junior, Ivan O. G. Mego, and Guilherme S. Mendonça: contributed to the data collection and statistical analysis; Rafael Nakamura-Silva: contributed to the evaluation and classification of the antimicrobial susceptibility profile of the strains; André Pitondo-Silva: conceived and designed the study, formal analysis, investigation, supervision, project administration, and funding acquisition. All authors contributed to writing and reviewing this manuscript.

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Correspondence to André Pitondo-Silva.

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Ethical approval was received from the Human Subject Research Ethics Committee of Universidade de Ribeirão Preto, Brazil [CAAE: 34839520.4.1001.5498].

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Dias, L.L., Nakamura-Silva, R., de Oliveira Junior, G.A.T. et al. Hospital liquid waste contaminated with multidrug-resistant bacteria raises a public health hazard alert in Brazil. Environ Monit Assess 193, 719 (2021). https://doi.org/10.1007/s10661-021-09477-1

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