Molecular Identification of Multidrug-resistant Bacteria in Hospital Wastewater
A Systematic Review
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Abstract
Hospital wastewater is a significant reservoir for multidrug-resistant (MDR) bacteria, which facilitates the spread of antibiotic resistance genes (ARGs) into the environment. This review synthesizes molecular techniques used to identify MDR bacteria in hospital wastewater, providing a comprehensive understanding of the genetic determinants, resistance mechanisms, and dissemination dynamics. A systematic review of studies published between 2010 and 2025 was conducted, focusing on molecular methods such as 16S rRNA gene sequencing, whole-genome sequencing (WGS), PCR-based assays, and metagenomics to characterize MDR bacteria in hospital effluents. Key findings reveal that Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii are the most commonly identified MDR species in hospital wastewater, with key ARGs, such as blaCTX-M, blaNDM, mecA, and tet, often associated with plasmids and integrons. Horizontal gene transfer is a dominant mechanism for resistance dissemination. The integration of molecular tools with environmental surveillance is essential to enhance the detection of MDR bacteria and understand their genetic diversity, ultimately informing strategies to curb the spread of resistance in hospital settings. The molecular identification of MDR bacteria in hospital wastewater is crucial for developing effective wastewater treatment protocols, antibiotic stewardship strategies, and public health interventions to combat antimicrobial resistance.
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Copyright (c) 2026 Sarah Oluwaseun Julius, Nwafor Peter Obinna, Auwal Shehu Ali, Christopher Ugwu Onyema, Muhammad Muhsin Umar, Tijani Adetola Fausiyah, Akerele Atinuke Oluwakemi, Chizaram Onyeaghala (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Sarah Oluwaseun Julius, University of Ibadan; Department of Microbiology, National Obstetric Fistula Center Abakaliki, Nigeria.
Department of Microbiology
Research student
Nwafor Peter Obinna, Department of Medical Laboratory Sciences, Nigeria.
Department: Medical Laboratory Sciences
Rank: Research student
Auwal Shehu Ali, Department of Pharmacy, Federal Teaching Hospital Katsina, Nigeria.
Department of Pharmacy
Rank: Graduate Student
Christopher Ugwu Onyema, Department of Public Health, Ahmadu Bello University Zaria, Nigeria.
Department of Public Health.
Rank: Graduate student
Muhammad Muhsin Umar, Department of Microbiology Bayero University Kano, Nigeria.
Department of Microbiology
Rank: Research student
Tijani Adetola Fausiyah, Department of Biological Sciences Southwestern University of Nigeria.
Department of Biological Science
Rank: Research student
Akerele Atinuke Oluwakemi, Department of Microbiology Lagos State University, Nigeria.
Department: Microbiology
Rank; Graduate student
Chizaram Onyeaghala, Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Nigeria.
Department of Internal Medicine
Rank: Consultant Physician
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