Antimicrobial resistance in bacteria isolated from hospital wastewater

Antimicrobial resistance (AMR) is a critical global public health problem, closely linked to the intensive use of antibiotics and the release of hospital effluents into the environment. To understand the role of hospital wastewater (HWW) in the dissemination of bacterial resistance to antimicrobials and its impact on public and animal health, a literature review was conducted using scientific databases. Studies show that HWW contains antibiotics at sublethal concentrations and a high load of multidrug-resistant pathogens, including Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, which carry genes encoding carbapenemases or beta-lactamases. These pathogens persist after conventional purification treatments and are disseminated in the environment. It is concluded that AMR constitutes a critical threat to global public health that transcends the clinical setting and involves the environment and animal health. The evidence gathered indicates that HWW function as critical reservoirs and pathways for the dissemination of antimicrobial-resistant bacteria (ARBs) and antimicrobial resistance genes (AMRGs) into the environment. Therefore, a One Health approach is required to strengthen their treatment, environmental surveillance, and the rational use of antimicrobials.