Multidrug resistance mediated by β-lactamase in Gram-negative bacilli is a serious public health problem. Sewers are considered reservoirs of multiresistant bacteria due to presence of antibiotics that select them and favor their dissemination. The present study evaluated the antibiotic resistance profile and β-lactamases production in Gram-negative bacilli isolates from hospital sewage and urban wastewater treatment plants (UWWTP) in Brazil. Bacteria were isolated and identified with biochemical tests. Antibiotic susceptibility testing was performed by the disk-diffusion method and detection of extended-spectrum β-lactamase and carbapenemases by enzymatic inhibitor and conventional PCR. Differences in resistance to amoxicillin clavulanic, aztreonam, cefepime, and cefotaxime were observed in hospital sewage compared with urban sewage (p < 0.05). The multidrug-resistant phenotype was observed in 33.3% of hospital sewage isolates (p = 0.0025). β-lactamases genes were found in 35.6% of isolates, with the most frequent being bla_KPC and bla_TEM (17.8%), and bla_SHV and bla_CTX-M (13.3% and 8.9%, respectively). The data obtained are relevant, since the bacteria detected are on the priority pathogens list from the World Health Organization and hospital sewage could be released untreated into the municipal collection system, which may favor the spread of resistance. Changes in hospital sewage discharge practices, as well as additional technologies regarding effluent disinfection in the UWWTP, can prevent the spread of these bacteria into the environment and negative impact on water resources.

中文翻译：

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巴西医院和城市污水中带有β-内酰胺酶编码基因的革兰氏阴性细菌。

β-内酰胺酶介导的革兰氏阴性杆菌多药耐药性是一个严重的公共卫生问题。下水道被认为是具有多重耐药性的细菌的储存库，因为存在选择它们并有利于其传播的抗生素。本研究评估了巴西医院污水处理厂和城市污水处理厂（UWWTP）的革兰​​氏阴性杆菌分离物中的抗生素抗药性和β-内酰胺酶的产生。分离细菌并通过生化测试鉴定。通过圆盘扩散法进行了药敏试验，并通过酶抑制剂和常规PCR检测了广谱β-内酰胺酶和碳青霉烯酶。与城市污水相比，医院污水中对阿莫西林克拉维酸，氨曲南，头孢吡肟和头孢噻肟的耐药性有所不同（p  ＜0.05）。在33.3％的医院污水分离物中观察到了多药耐药表型（p  = 0.0025）。在35.6％的分离物中发现了β-内酰胺酶基因，最常见的是bla _KPC和bla _TEM（17.8％），以及bla _SHV和bla _CTX-M（分别为13.3％和8.9％）。获得的数据是相关的，因为检测到的细菌在世界卫生组织的优先病原体清单中，而且医院的污水可能未经处理就被释放到市政收集系统中，这可能有助于耐药性的传播。医院污水排放方式的变化，以及UWWTP中有关污水消毒的其他技术，可以防止这些细菌扩散到环境中，并避免对水资源造成负面影响。