Identification of extended-spectrum β-lactamase and quinolone resistance genes in Escherichia coli isolated from hospital wastewater from central India.

Objective: To investigate the presence of antibiotic resistance genes (ARGs), related to commonly used β-lactams and quinolones, in Escherichia coli present in hospital wastewater in central India.

Methods: Cefotaxime- and ciprofloxacin-resistant E. coli isolates from hospital-associated wastewater samples were collected from two tertiary care hospitals in the Ujjain district of India during 2008-09. The presence of bla(CTX-M), bla(TEM,) bla(SHV), qnrA, qnrB, qnrS, aac(6')-Ib-cr and qepA genes was detected by PCR and sequencing.

Results: Twenty-five E. coli isolates were extended-spectrum β-lactamase (ESBL) positive. bla(CTX-M-15) and bla(TEM-1) genes were identified in 21 and 16 ESBL-positive isolates by PCR, respectively. Amongst 30 fluoroquinolone-resistant E. coli isolates, aac(6')-Ib-cr was detected in 27 isolates, qnrA in 1 isolate, qnrB in 2 isolates and qepA in 3 isolates.

Conclusions: bla(CTX-M-15,) bla(TEM-1), aac(6')-Ib-cr, qnrA, qnrB and qepA genes are present in E. coli occurring in hospital wastewater in central India.