Characterization of Ciprofloxacin resistant Extended Spectrum β -Lactamase (ESBL) producing Escherichia spp. from clinical waste water in Bangladesh

Clinical Waste Water (CWW) possesses the risks of spreading antibiotic resistant bacteria in the environment. In Bangladesh, liquid discharge is directly released into the municipal sewage system and pollutes the surroundings water bodies/rivers. Liquid samples were collected from the three CWW discharge sites connected to DMCH (Dhaka Medical College Hospital) and from one control group non-connected to DMCH. About 32, 30 and 26 times higher ciprofloxacin, cefixime and multi-drug resistant bacterial count were found in CWW over control samples. Among the isolates, two Escherichia spp. isolates, denoted 26N and 28N, were found to be resistant against fluoroquinolone (MBC of Ciprofloxacin > 1024 μg/ml), cephalosporin, glycopeptide, monobactam, penicillin, tetracycline, rifampicin, macrolides, sulfonamide and nitrofuran classes of drugs and were also ESBL positive through phenotypic assay. Plasmid curing experiment detected possible plasmid mediated resistance of fluoroquinolone, cephalosporin, tetracycline, lincosamide and nitrofuran classes of antibiotics. Phylogenetically, isolate 26N and 28N were characterized as Escherichia coli and Escherichia fergusonii. These MDR and ESBL positive bacteria are potent to disseminate resistant determinants in the surrounding environments.